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D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study.
Hachim, Mahmood Y; Hachim, Ibrahim Y; Naeem, Kashif Bin; Hannawi, Haifa; Salmi, Issa Al; Hannawi, Suad.
  • Hachim MY; College of Medicine, Mohammed bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
  • Hachim IY; Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
  • Naeem KB; Ministry of Health and Prevention (MOHAP), Dubai, United Arab Emirates.
  • Hannawi H; Ministry of Health and Prevention (MOHAP), Dubai, United Arab Emirates.
  • Salmi IA; The Royal Hospital, Muscat, Oman.
  • Hannawi S; Ministry of Health and Prevention (MOHAP), Dubai, United Arab Emirates.
Front Med (Lausanne) ; 7: 585003, 2020.
Article in English | MEDLINE | ID: covidwho-1556373
ABSTRACT

Background:

Identifying clinical-features or a scoring-system to predict a benefit from hospital admission for patients with COVID-19 can be of great value for the decision-makers in the health sector. We aimed to identify differences in patients' demographic, clinical, laboratory, and radiological findings of COVID-19 positive cases to develop and validate a diagnostic-model predicting who will develop severe-form and who will need critical-care in the future.

Methods:

In this observational retrospective study, COVID-19 positive cases (total 417) diagnosed in Al Kuwait Hospital, Dubai, UAE were recruited, and their prognosis in terms of admission to the hospital and the need for intensive care was reviewed until their tests turned negative. Patients were classified according to their clinical state into mild, moderate, severe, and critical. We retrieved all the baseline clinical data, laboratory, and radiological results and used them to identify parameters that can predict admission to the intensive care unit (ICU).

Results:

Patients with ICU admission showed a distinct clinical, demographic as well as laboratory features when compared to patients who did not need ICU admission. This includes the elder age group, male gender, and presence of comorbidities like diabetes and history of hypertension. ROC and Precision-Recall curves showed that among all variables, D dimers (>1.5 mg/dl), Urea (>6.5 mmol/L), and Troponin (>13.5 ng/ml) could positively predict the admission to ICU in patients with COVID-19. On the other hand, decreased Lymphocyte count and albumin can predict admission to ICU in patients with COVID-19 with acceptable sensitivity (59.32, 95% CI [49.89-68.27]) and specificity (79.31, 95% CI [72.53-85.07]).

Conclusion:

Using these three predictors with their cut of values can identify patients who are at risk of developing critical COVID-19 and might need aggressive intervention earlier in the course of the disease.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2020 Document Type: Article Affiliation country: FMED.2020.585003

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2020 Document Type: Article Affiliation country: FMED.2020.585003