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Haematological predictors of poor outcome among COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa.
Chapanduka, Zivanai C; Abdullah, Ibtisam; Allwood, Brian; Koegelenberg, Coenraad F; Irusen, Elvis; Lalla, Usha; Zemlin, Annalise E; Masha, Tandi E; Erasmus, Rajiv T; Jalavu, Thumeka P; Ngah, Veranyuy D; Yalew, Anteneh; Sigwadhi, Lovemore N; Baines, Nicola; Tamuzi, Jacques L; McAllister, Marli; Barasa, Anne K; Magutu, Valerie K; Njeru, Caroline; Amayo, Angela; Wanjiru Mureithi, Marianne W; Mungania, Mary; Sono-Setati, Musa; Zumla, Alimuddin; Nyasulu, Peter S.
  • Chapanduka ZC; Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University & NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Abdullah I; Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University & NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Allwood B; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University & Tygerberg Hospital, Cape Town, South Africa.
  • Koegelenberg CF; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University & Tygerberg Hospital, Cape Town, South Africa.
  • Irusen E; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University & Tygerberg Hospital, Cape Town, South Africa.
  • Lalla U; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University & Tygerberg Hospital, Cape Town, South Africa.
  • Zemlin AE; Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University & NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Masha TE; Faculty of Health & Wellness Sciences, Peninsula University of Technology Bellville Campus, Cape Town, South Africa.
  • Erasmus RT; Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University & NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Jalavu TP; Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University & NHLS Tygerberg Hospital, Cape Town, South Africa.
  • Ngah VD; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, 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.
  • Sigwadhi LN; Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
  • Baines N; National Data Management Centre for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Tamuzi JL; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • McAllister M; Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University & Tygerberg Hospital, Cape Town, South Africa.
  • Barasa AK; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, 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 Medical Microbiology, University of Nairobi, Nairobi, Kenya.
  • Amayo A; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.
  • Wanjiru Mureithi MW; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.
  • Mungania M; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.
  • Sono-Setati M; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.
  • Zumla A; Department of Laboratory Medicine, Kenyatta National Hospital, Nairobi, Kenya.
  • Nyasulu PS; Department of Public Health Medicine, Department of Health, Limpopo, South Africa.
PLoS One ; 17(11): e0275832, 2022.
Article in English | MEDLINE | ID: covidwho-2109322
ABSTRACT

BACKGROUND:

Studies from Asia, Europe and the USA indicate that widely available haematological parameters could be used to determine the clinical severity of Coronavirus disease 2019 (COVID-19) and predict management outcome. There is limited data from Africa on their usefulness in patients admitted to Intensive Care Units (ICUs). We performed an evaluation of baseline haematological parameters as prognostic biomarkers in ICU COVID-19 patients.

METHODS:

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

RESULTS:

A total of 490 patients (median age 54.1 years) were included, of whom 237 (48%) were female. The median duration of ICU stay was 6 days and 309/490 (63%) patients died. Raised neutrophil count and neutrophil/lymphocyte ratio (NLR) were associated with worse outcome. Independent risk factors associated with mortality were age (ARR 1.01, 95%CI 1.0-1.02; p = 0.002); female sex (ARR 1.23, 95%CI 1.05-1.42; p = 0.008) and D-dimer levels (ARR 1.01, 95%CI 1.002-1.03; p = 0.016).

CONCLUSIONS:

Our study showed that raised neutrophil count, NLR and D-dimer at the time of ICU admission were associated with higher mortality. Contrary to what has previously been reported, our study revealed females admitted to the ICU had a higher risk of mortality.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Africa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0275832

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Africa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0275832