Millennium COVID-19 Care Center, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Faculty of Medicine and Health Sciences, Divison of Epidemiology and Biostatistics, Stellenbosch University, Cape Town, South Africa.
PLoS One. 2021 Mar 15;16(3):e0246087. doi: 10.1371/journal.pone.0246087. eCollection 2021.
To identify laboratory biomarkers that predict disease severity and outcome among COVID-19 patients admitted to the Millennium COVID-19 Care Center in Ethiopia.
A retrospective cohort study was conducted among 429 COVID-19 patients who were on follow up from July to October 2020. Data was described using frequency tables. Robust Poisson regression model was used to identify predictors of COVID-19 severity where adjusted relative risk (ARR), P-value and 95 CI for ARR were used to test significance. Binary Logistic regression model was used to assess the presence of statistically significant association between the explanatory variables and COVID-19 outcome where adjusted odds ratio (AOR), P-value and 95%CI for AOR were used for testing significance.
Among the 429 patients studied, 182 (42.4%) had Severe disease at admission and the rest 247 (57.6%) had Non-severe disease. Regarding disease outcome, 45 (10.5%) died and 384 (89.5%) were discharged alive. Age group (ARR = 1.779, 95%CI = 1.405-2.252, p-value <0.0001), Neutrophil to Lymphocyte ratio (NLR) (ARR = 4.769, 95%CI = 2.419-9.402 p-value <0.0001), Serum glutamic oxaloacetic transaminase (SGOT) (ARR = 1.358, 95%CI = 1.109-1.662 p-value = 0.003), Sodium (ARR = 1.321, 95%CI = 1.091-1.600 p-value = 0.004) and Potassium (ARR = 1.269, 95%CI = 1.059-1.521 p-value = 0.010) were found to be significant predictors of COVID-19 severity. The following factors were significantly associated with COVID-19 outcome; age group (AOR = 2.767, 95%CI = 1.099-6.067, p-value = 0.031), white blood cell count (WBC) (AOR = 4.253, 95%CI = 1.918-9.429, p-value = 0.0001) and sodium level (AOR = 3.435, 95%CI = 1.439-8.198, p-value = 0.005).
Assessing and monitoring the laboratory markers of WBC, NLR, SGOT, sodium and potassium levels at the earliest stage of the disease could have a considerable role in halting disease progression and death.
确定在埃塞俄比亚千年 COVID-19 护理中心收治的 COVID-19 患者中预测疾病严重程度和结局的实验室生物标志物。
对 2020 年 7 月至 10 月期间接受随访的 429 名 COVID-19 患者进行了回顾性队列研究。使用频率表描述数据。使用稳健泊松回归模型来确定 COVID-19 严重程度的预测因素，其中调整后的相对风险 (ARR)、P 值和 ARR 的 95%CI 用于检验显著性。使用二元逻辑回归模型评估解释变量与 COVID-19 结局之间是否存在统计学显著关联，其中调整后的优势比 (AOR)、P 值和 AOR 的 95%CI 用于检验显著性。
在所研究的 429 名患者中，182 名（42.4%）入院时患有严重疾病，其余 247 名（57.6%）患有非严重疾病。关于疾病结局，45 人（10.5%）死亡，384 人（89.5%）存活出院。年龄组（ARR = 1.779，95%CI = 1.405-2.252，p 值 <0.0001）、中性粒细胞与淋巴细胞比值（NLR）（ARR = 4.769，95%CI = 2.419-9.402，p 值 <0.0001）、血清谷氨酸草酰乙酸转氨酶（SGOT）（ARR = 1.358，95%CI = 1.109-1.662，p 值 = 0.003）、钠（ARR = 1.321，95%CI = 1.091-1.600，p 值 = 0.004）和钾（ARR = 1.269，95%CI = 1.059-1.521，p 值 = 0.010）被发现是 COVID-19 严重程度的显著预测因素。以下因素与 COVID-19 结局显著相关；年龄组（AOR = 2.767，95%CI = 1.099-6.067，p 值 = 0.031）、白细胞计数（WBC）（AOR = 4.253，95%CI = 1.918-9.429，p 值 = 0.0001）和钠水平（AOR = 3.435，95%CI = 1.439-8.198，p 值 = 0.005）。
在疾病的最早阶段评估和监测白细胞计数、NLR、SGOT、钠和钾水平的实验室标志物可能在阻止疾病进展和死亡方面发挥重要作用。
