Predictors of disease severity in patients hospitalized with coronavirus disease 2019.

BACKGROUND

Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, manifests as a respiratory illness primarily and symptoms range from asymptomatic to severe respiratory syndrome and even death. During the pandemic, due to overcrowding of medical facilities, clinical assessment to triage patients for home care or in-hospital treatment was an essential element of management.

OBJECTIVES

Study the demographic features, comorbidities and bio-markers that predict severe illness and mortality from COVID-19 infection.

DESIGN

Retrospective observational SETTING: Single tertiary care center PATIENTS AND METHODS: The study included all patients admitted with a positive PCR test for COVID-19 during the period from March 2020 to September 2020 (7 months). Data on demographics, clinical data and laboratory parameters was collected from medical records every 3 days during hospital stay or up until transfer to ICU.

MAIN OUTCOME MEASURES

Demographic, comorbidities and biochemical features that might predict severe COVID-19 disease.

SAMPLE SIZE

372 RESULTS: Of the 372 patients, 72 (19.4%) had severe disease requiring admission to intensive care unit (ICU); 6 (1.6%) died. Individuals over 62 years were more likely to be admitted to the ICU (=.0001, while a BMI of 40 and higher increased the odds of severe disease (=.032). Male gender (=.042), hypertension (=.006) and diabetes (=.001) conferred a statistically significant increased risk of admission to ICU, while coexisting COPD, and ischemic heart disease did not. Laboratory features related to severe COVID-19 infection were: leukocytosis (=.015), thrombocytopenia (=.001), high levels of C-reactive protein (=.0001), lactic dehydrogenase (=.0001), D-dimer (=.0001) and ferritin (=.001). With the multivariate analysis, diabetes, high lac-tate dehydrogenase, C-reactive protein and thrombocytopenia were associated with severity of illness.

CONCLUSIONS

Particular demographic and clinical parameters may predict severe illness and need for ICU care.

LIMITATIONS

Single referral center, several cases of severe COVID-19 could not be included due to lack of consent and or data.

CONFLICT OF INTEREST

None.