Bairwa Mukesh, Kumar Rajesh, Beniwal Kalpana, Kalita Deepjyoti, Bahurupi Yogesh
Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
Clin Epidemiol Glob Health. 2021 Jul-Sep;11:100770. doi: 10.1016/j.cegh.2021.100770. Epub 2021 May 8.
Coronavirus disease is primarily transmitted through the respiratory route and bodily contact. The fatality in COVID-19 cases was alarming in the initial days. This study analyzes hematological and biochemical markers of COVID-19 non-survivors
In this single-center study, records of 249 patients hospitalized with COVID-19 were studied for hematological profile and biochemical markers. Records of patients with laboratory-confirmed COVID-19 disease hospitalized between April 14, 2020, to August 15, 2020, were included in the analysis.
Significantly, the disease mortality was associated with increased procalcitonin ( < 0.05), C-reactive protein ( < 0.05), aspartate transaminase ( < 0.05), serum potassium ( < 0.05), neutrophils count ( < 0.05), white blood cell count ( < 0.05), prothrombin time ( < 0.05) and activated prothrombin time ( < 0.05) in patients reported abnormal x-ray findings. Further, patients with abnormal radiological findings significantly showed a reduced level of lymphocyte counts ( < 0.05), oxygen saturation ( < 0.05), and partial oxygen pressure ( < 0.05). Reduced level of aspartate aminotransferase ( < 0.05), alanine aminotransferase ( < 0.05) and lactate dehydrogenase ( < 0.05) reported significant association with mortality among patients with COVID-19.
The clinicians may consider the hematological and biochemical parameters in the patients with COVID-19 in future decision-making. These indicators might support clinical decisions to identify high fatality cases and poor diagnosis in the initial admission phase. In COVID-19 patients, we recommend close monitoring on procalcitonin, C-reactive protein, neutrophils count, and white blood cell count as a clinical indicator for potential progression to critical illness.
冠状病毒病主要通过呼吸道途径和身体接触传播。在最初几天,COVID-19病例的死亡率令人担忧。本研究分析了COVID-19非幸存者的血液学和生化指标。
在这项单中心研究中,对249例因COVID-19住院的患者的血液学特征和生化指标记录进行了研究。分析纳入了2020年4月14日至2020年8月15日期间实验室确诊为COVID-19疾病并住院的患者记录。
值得注意的是,在报告有异常x光检查结果的患者中,疾病死亡率与降钙素原升高(<0.05)、C反应蛋白升高(<0.05)、天冬氨酸转氨酶升高(<0.05)、血清钾升高(<0.05)、中性粒细胞计数升高(<0.05)、白细胞计数升高(<0.05)、凝血酶原时间升高(<0.05)和活化凝血酶原时间升高(<0.05)相关。此外,有异常影像学检查结果的患者显著表现出淋巴细胞计数降低(<0.05)、血氧饱和度降低(<0.05)和血氧分压降低(<0.05)。COVID-19患者中天冬氨酸转氨酶降低(<0.05)、丙氨酸转氨酶降低(<0.05)和乳酸脱氢酶降低(<0.05)与死亡率显著相关。
临床医生在未来的决策中可能会考虑COVID-19患者的血液学和生化参数。这些指标可能有助于支持临床决策,以识别初始入院阶段的高死亡病例和诊断不佳的病例。在COVID-19患者中,我们建议密切监测降钙素原、C反应蛋白、中性粒细胞计数和白细胞计数,作为潜在进展为危重病的临床指标。