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Review paper

Early predictors of severity and mortality in COVID-19 hospitalized patients

By
Sehveta Mustafić Orcid logo ,
Sehveta Mustafić
Contact Sehveta Mustafić

Department of Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina

Edin Jusufović ,
Edin Jusufović

Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina

Department of Pulmonology, Public Educational and Health Centre, Tuzla, Bosnia and Herzegovina

Fatima Hukić ,
Fatima Hukić

Department of Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina

Emir Trnačević ,
Emir Trnačević

Department of Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Pharmaceutical Faculty, University in Tuzla, Tuzla, Bosnia and Herzegovina

Anja Divković ,
Anja Divković

Department of Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Pharmaceutical Faculty, University in Tuzla, Tuzla, Bosnia and Herzegovina

Alma Trnačević
Alma Trnačević

Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina

Department of Infectious Diseases, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Abstract

Aim
To identify laboratory tests for early detection and the development of more severe illness and death in COVID-19 hospitalized patients.
Methods
A prospective study was done on 66 hospitalized COVID-19 patients (males: 54.5%; mean age 70.1 ± 9.6 years)
who were stratified into: moderate (n=36; 54.5%), severe (n=12; 18.2%), and critically ill (n=18; 27.3%). Besides clinical findings, a wide spectrum of laboratory parameters was monitored at admission and control during the first seven days of hospitalization and used to predict progression from non-severe to severe illness and to predict the final outcome.
Results
Critically ill patients showed a higher control value of white blood cell count, C-reactive protein, lactate dehydrogenase,
ferritin, but lower lymphocyte count and O2 saturation. Patients with fatal outcome (23; 34.85%) showed a higher control value of neutrophil, lactate dehydrogenase, ferritin, and lower lymphocyte and O2 saturation. Progression from moderate to severe or critical illness was predicted by increasing lactate dehydrogenase (95% CI 0.5803 to 0.8397;p=0.003729), increase in ferritin (95% CI 0.5288 to 0.8221;p=0.03248), and by drop in O2 saturation (95% CI 0.5498 to 0.8179;p=0.01168). A fatal outcome was predicted by increase in ferritin (95% CI 0.5059 to 0.8195;p=0.04985),
as well as by drop in O2 saturation (95% CI 0.5916 to 0.8803; p=0.001861).
Conclusion
Increase in ferritin, and drop in O2 saturation could be the most important prognostic parameters for the development of
more severe clinical illness and death in COVID-19 hospitalized patients.

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