Association of biomarkers and severity of COVID-19: A crosssectional study. / Asociación de biomarcadores y severidad de COVID-19: estudio transversal.

ABSTRACT

Introduction COVID- 19 is a disease that has claimed the lives of many people. However, alterations in labo-ratory profiles in the city of Tacna have not been accurately established in association with its severity to support diagnosis and treatment. Objective To determine biomarkers related to the severity of COVID- 19 in patients treated at the social security hospital in Tacna during 2020. Methods We performed an observational, cross- sectional, and analytical study that included 308 patients with COVID- 19 from the social security hospital in Tacna, Peru, during the "first wave" of the pandemic (from July to August 2020). Immunological, hematological, arterial gas, hemostasis, and biochemical markers were collected. Patients were categorized into mild, moderate, and severe based on the clinical criteria found on clinical records. Correlation strength was per-formed according to Spearman's Rho coefficient. The performance of the biomarkers associat-ed with severity was analyzed with the Receiver Operating Characteristic curve. Results Regarding hematological markers there was a positive correlation with monocyte count (correla-tion coefficient 0.841; area under the curve 97.0%; p < 0.05) and a negative correlation with lymphocyte count (correlation coefficient -0.622; area under the curve 82.7%; p < 0.05). Regarding biochemical markers, arterial gases and hemostasis, no significant correlations were found. In immunological markers, we found positive correlation with ferritin (correlation coef-ficient 0.805; area under the curve 94.0%; p < 0.05), and C- reactive protein (correlation coeffi-cient 0.587; area under the curve 87.4%; p < 0.05). Conclusions The biomarkers that can be considered as parameters associated with the severity of COVID- 19 are the absolute blood count of monocytes and serum ferritin concentration.

RESUMEN

Introducción COVID- 19, es una enfermedad que ha cobrado la vida de muchas personas. Sin embargo, las alteraciones en los perfiles de labora-torio en la ciudad de Tacna, no han sido establecidas de manera precisa en asociacion a su gravedad para apoyo en el diagnostico y tratamiento. Objetivo Determinar los biomarcadores que esten relacionados al grado de severidad de los pacientes COVID- 19 atendidos en el hospital de la seguridad social, en Tacna durante 2020. Métodos Estudio observacional, transversal y analitico. Conformado por 308 pacientes con COVID- 19 del hospital de la seguridad social de la ciudad de Tacna, Peru, durante el golpe de la "primera ola" (de julio a agosto de 2020). Se recolectaron resultados de marcadores inmunologicos, hematologicos, gases arteriales, hemostasia y bioquimicos. Los pacientes se categorizaron en leves, moderados y severos, basandonos en el criterio medico ­ clinico de la historia clinica. Las correlaciones y fuerza de correlacion fueron realizadas segun coeficiente Rho de Spearman. El rendimiento de los biomarcadores asociado a la gravedad, se realizo con curva Receiver Operating Characteristic. Resultados En marcadores hematologicos existe correlacion positiva con recuento de monocitos (coeficiente de correlacion 0,841; area bajo la curva 97,0%; p < 0,05) y correlacion negativa con recuento de linfocitos (coeficiente de correlacion -0,622; area bajo la curva 8.27%; p < 0,05). En marcadores bioquimicos, gases arteriales y hemostasia, no se hallaron correlaciones significativas. En marcadores in-munologicos, encontramos correlacion positiva con ferritina (coeficiente de correlacion 0,805; area bajo la curva 94,0%; p < 0,05), y proteina C reactiva (coeficiente de correlacion 0,587; area bajo la curva 87,4%; p < 0,05). Conclusiones Los biomarcadores que pueden considerarse como parametros asociados a la gravedad de COVID- 19, son el recuento sanguineo absoluto de monocitos y la concentracion serica de ferritina.