Clinical and laboratory features of COVID‐19‐patients in severe and extremely severe condition: 616‐06

Abstract

Summary. Introduction. Patients with COVID‐19 may develop complications that result in lethal outcomes as the disease progresses. Such complications include acute respiratory distress syndrome (ARDS), stroke, myocardial infarction, and multiple organ failure syndrome. Therefore, at earlier disease stages, it is vital to have available markers for the potential development of severe COVID‐19 and possible unfavorable outcomes of this disease. Aim: to determine the risk factors for death in hospitalized patients with severe and extremely severe COVID‐19. Materials and Methods. From June 18, 2020 to August 18, 2020, a retrospective uncontrolled open study was conducted at the Infectious Diseases Hospital of the Bashkir State Medical University Clinic (Ufa). We examined a total of 65 patients aged from 35 to 91 years (average age 64.7±13.5 years). These patients were diagnosed with COVID‐19, as confirmed by polymerase chain reaction, and were hospitalized in severe and extremely severe condition. The patients were divided into two groups depending on the disease outcome: 32 (49%) patients were discharged from the hospital (group 1), while 33 (51%) died during hospitalization (group 2). Laboratory parameters were analyzed, including C‐reactive protein (CRP) level, the relative number of lymphocytes (%) in the general blood test, the lymphocyte/CRP ratio, the neutrophil/lymphocyte ratio, ferritin, procalcitonin, presepsin, IL‐6 and IL‐10 interleukins (interleukin, IL), D‐dimer, and membrane attack complex (MAC) level and their correlation with the clinical course of the disease. Results. Mechanical ventilation was performed in 38 (58.5%) patients: in 8 patients in group 1 and 30 patients in group 2. Concomitant therapy analysis revealed that corticosteroids were more frequently prescribed to patients in group 2 (among deceased patients). The probability of survival in patients was 63.78%, while the probability of death was 36.22%. The highest mortality rate was observed in patients over 80 years of age. In both groups of patients, deviations in laboratory parameters that could be determined in real clinical practice were identified. During the entire hospitalization period, significant differences were observed between the groups (p < 0.05) for the following parameters: lymphocyte count, CRP, D‐dimer, procalcitonin, IL‐6, and IL‐10 levels. No significant differences were found between the groups in ferritin, prepepsin, and MAC levels. Significant intergroup differences (p < 0.05 for two or more measurements throughout the study) were observed for the following parameters: age, lymphocyte count, IL‐6 and CRP levels, as well as the IL‐6/CRP ratio. Conclusion. Based on the data obtained, a regression model was constructed and a decision tree analysis was performed to classify patients and determine the probability of outcome.

For citation: Nabieva A.A., Kudlay D.A., Tregubova A.Kh., Bakirov B.A., Morozovsky D.V., Efimova V.V., Ladutko A.A. Clinical and laboratory features of COVID‐19‐patients in severe and extremely severe condition. Tromboz, gemostaz i reologiya. 2024;(3):75–86. (In Russ.).

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