Original article

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

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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

How to Cite:

Mustafić, S., Jusufović, E., Hukić, F., Trnačević, E., Divković, A. & Trnačević, A., (2021) “Early predictors of severity and mortality in COVID-19 hospitalized patients”, Medicinski glasnik 18(2), 384-393. doi: https://doi.org/10.17392/1349-21