Comparative Analyses of Clinical, Laboratory, and Radiological Findings between COVID-19 Deceased and Recovered Patients.

ABSTRACT

Background Understanding the coronavirus disease 2019 (COVID-19)-specific indices has become important with increasing cases of COVID-related in-hospital mortality. Objective This case-control study compared clinical, laboratory, and radiological findings between deceased and recovered COVID-19 patients and identified the significant biomarkers associated with deceased patients. Method An analysis of clinical, laboratory, and radiological findings of COVID-19 patients admitted to the COVID-dedicated wards of Nepal Armed Police Force Hospital between March and December 2021 was performed using SPSS version 17.0, with statistical significance considered at p < 0.05. Result A total of 187 COVID-19 patients, comprising deceased [n=95, median (interquartile range, IQR) age 66 (53-76) years, male 61 (64.2%) (p=0.024)] and recovered [n=92, median (IQR) age 51 (38-61) years, male 44 (47.8%)], were included in the study. Compared to recovered COVID-19 patients, deceased patients had increased median respiratory (20 versus 29.5 breaths/minute) and pulse (83 vs. 86 beats/minute) rates; multiple co-morbidities (≥ 2) (11.9% vs. 32.6%) (p < 0.001); significantly (p < 0.05) lowered alkaline phosphatase (ALP), total protein (TP), albumin, lymphocytes, monocytes, eosinophil, hemoglobin and significantly (p < 0.05) elevated glucose, lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate aminotransferase (AST), leucocytes, neutrophils, D-dimer and C-reactive protein (CRP); and chest abnormalities including bilateral (p < 0.001), peripheral (p < 0.001) interstitial (p < 0.001) and ground glass opacity (GGO) (p=0.002). Conclusion Elderly, male sex, increased respiratory and pulse rate, presence of multiple comorbidities, lowered levels of ALP, TP, albumin, lymphocytes, monocytes, eosinophils, hemoglobin, elevated levels of glucose, LDH, ALT, AST, leucocytes, neutrophils, D-dimer, CRP, and chest X-rays showing bilateral, peripheral interstitial and GGO abnormalities were the significant indices associated with deceased COVID-19 patients.