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Prognostic value of biochemical parameters among severe COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa.
Zemlin, Annalise E; Allwood, Brian; Erasmus, Rajiv T; Matsha, Tandi E; Chapanduka, Zivanai C; Jalavu, Thumeka P; Ngah, Vera; Sigwadhi, Lovemore N; Koegelenberg, Coenraad F; Irusen, Elvis; Lalla, Usha; Yalew, Anteneh; Baines, Nicola; Tamuzi, Jacques L; Barasa, Anne K; Magutu, Valerie Kemunto; Njeru, Caroline; Amayo, Angela; Mureithi, Marianne Wanjiru; Mungania, Mary; Sono-Setati, Musa; Zumla, Alimuddin; Nyasulu, Peter S.
  • Zemlin AE; Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Allwood B; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
  • Erasmus RT; Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Matsha TE; Faculty of Health and Wellness Sciences, Peninsula University of Technology, Bellville Campus, Cape Town, South Africa.
  • Chapanduka ZC; Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Jalavu TP; Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Ngah V; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Sigwadhi LN; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Koegelenberg CF; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
  • Irusen E; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
  • Lalla U; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
  • Yalew A; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Baines N; Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
  • Tamuzi JL; National Data Management Centre for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Barasa AK; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
  • Magutu VK; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Njeru C; Department of Human Pathology, School of Medicine, University of Nairobi, Nairobi, Kenya.
  • Amayo A; Department of Human Pathology, School of Medicine, University of Nairobi, Nairobi, Kenya.
  • Mureithi MW; Department of Human Pathology, School of Medicine, University of Nairobi, Nairobi, Kenya.
  • Mungania M; Department of Human Pathology, School of Medicine, University of Nairobi, Nairobi, Kenya.
  • Sono-Setati M; Department of Human Pathology, School of Medicine, University of Nairobi, Nairobi, Kenya.
  • Zumla A; Department of Pathology, Kenyatta National Hospital, Nairobi, Kenya.
  • Nyasulu PS; Department of Public Health Medicine, Department of Health, Limpopo, South Africa.
IJID Reg ; 2: 191-197, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1639444
ABSTRACT

Background:

Data on biochemical markers and their association with mortality rates in patients with severe coronavirus disease 2019 (COVID-19) admitted to intensive care units (ICUs) in sub-Saharan Africa are scarce. An evaluation of baseline routine biochemical parameters was performed in COVID-19 patients admitted to the ICU, in order to identify prognostic biomarkers.

Methods:

Demographic, clinical, and laboratory data were collected prospectively from patients with PCR-confirmed COVID-19 admitted to the adult ICU of a tertiary hospital in Cape Town, South Africa, between October 2020 and February 2021. Robust Poisson regression methods and the receiver operating characteristic (ROC) curve were used to explore the association of biochemical parameters with severity and mortality.

Results:

A total of 82 patients (median age 53.8 years, interquartile range 46.4-59.7 years) were enrolled, of whom 55 (67%) were female and 27 (33%) were male. The median duration of ICU stay was 10 days (interquartile range 5-14 days); 54/82 patients died (66% case fatality rate). Baseline lactate dehydrogenase (LDH) (adjusted relative risk 1.002, 95% confidence interval 1.0004-1.004; P = 0.016) and N-terminal pro B-type natriuretic peptide (NT-proBNP) (adjusted relative risk 1.0004, 95% confidence interval 1.0001-1.0007; P = 0.014) were both found to be independent risk factors of a poor prognosis, with optimal cut-off values of 449.5 U/l (sensitivity 100%, specificity 43%) and 551 pg/ml (sensitivity 49%, specificity 86%), respectively.

Conclusions:

LDH and NT-proBNP appear to be promising predictors of a poor prognosis in COVID-19 patients in the ICU. Studies with a larger sample size are required to confirm the validity of this combination of biomarkers.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Journal: IJID Reg Year: 2022 Document Type: Article Affiliation country: J.ijregi.2022.01.012

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Journal: IJID Reg Year: 2022 Document Type: Article Affiliation country: J.ijregi.2022.01.012