PREDICTIVE RELEVANCE OF DIFFERENT CLINICAL AND LABORATORY FINDINGS FOR HIGHER MORTALITY IN PATIENTS WITH COVID-19 IN A SINGLE CENTER COHORT: NEUTROPHIL/LYMPHOCYTE RATIO, HIGH CRP, GGT AND CREATININE LEVELS ARE ASSOCIATED WITH HIGH MORTALITY

ABSTRACT

Objective: Early detection of mortality risk is important in patients diagnosed with of coronavirus disease 2019 (COVID-19). Therefore, we aimed to evaluate the predictive value of different clinical and laboratory parameters in disease severity and mortality in patients with COVID-19. Materials and Methods: Patients admitted to hospital with a diagnosis of COVID-19 were evaluated retrospectively. The patients' admission date, discharge date, intensive care transfer/death date, contact history, smoking, symptoms at the time admission, vital markers at admission, and laboratory parameters were recorded. Results: The study included a total of 347 patients, of whom 168 (48.4%) were women. The mean age of the patients was 59.69 +/- 16.87 (14-97) years, while 40.9% (n=142) were aged over 65 years. Overall, 10.1% (n=35) of the patients required transfer to an intensive care unit and 8.4% (n=29) were deceased. When clinical parameters were evaluated at the time of admission, oxygen saturation was found to be lower in the group that died. (79.51 +/- 6.95) compared to the survivors (88.78 +/- 6.11) (p<0.001). Additionally, male gender (p=0.05), advanced age (p<0.001), positive PCR result (p=0.036), congestive heart failure (p=0.044), severe COVID-19 involvement on thorax CT (p<0.001), and presence of at least one comorbidity (p=0.003) were observed at a higher rate in the mortality group. In the multivariate analyses, increased values of the NLR (HR 1.04, 95% CI 1.00-1.08), creatinine (OR 1.37, 95% CI 1.13-1.66), CRP (=-0.18, OR 0.98, 95% CI 0.97-0.99), GGT (OR 1.006, 95% CI 1.001-1.012), age (OR 5.67, 95% CI 2.24-14.38), male gender (OR 2.38, 95% CI 0.98-5.75), and presence of any comorbidity (OR 5.23, 95% CI 2.08-13.13) were associated with mortality. Conclusions: Several clinical and laboratory parameters, such as advanced age, male gender, presence of any comorbidity, and NLR, GGT, CRP and creatinine levels at the time of admission can predict mortality in COVID-19 patients. These parameters obtained at the time of admission can contribute to the reduction of mortality through a closer clinical and laboratory follow-up in these patients.