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Review paper
Received: 28.01.2020. >> Accepted: 01.04.2021. >> Published: 01.06.2021. Biochemistry
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https://doi.org/10.17392/1349-21

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

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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

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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

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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

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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

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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

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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.

Keywords:

ferritin,
LDH,
O2 saturation,
SARS-CoV-2

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