Predictors of disease severity, clinical course, and therapeutic outcome
in COVID-19 patients: Our experience with 1700 patients
Abstract
Objective: To investigate the impacts of demographic, hematological, and
biochemical factors on the clinical course and the prognostic outcome in
adult COVID-19 patients. Methods: This retrospective study was performed
in the internal medicine departments of 2 hospitals and data were
extracted from the medical files of 1700 adult COVID-19 patients (836
females, 49.2%; 864 males, 50.8%) with an average age of 48.23 ± 16.68
(range: 18-93). Clinical data included baseline descriptives, prior
medical history, admission date, treatment, and hematological and
biochemical blood test results. The relationship between the survival,
length of hospitalization, hematological, and biochemical parameters was
investigated. Results: Advanced age (p<0.001), presence of at
least 1 comorbid disease (p=0.045), increased length of hospitalization
(p=0.006), elevated white blood cell (p=0.001) and neutrophil (p=0.002)
counts, increased serum levels of glucose (p=0.027), blood urea nitrogen
(p<0.001), AST (p=0.006), LDH (p<0.001), CRP
(p>0.001), and D-dimer (p=0.001). In contrast, diminution
of serum levels of albumin (p<0.001), ALT (p=0.028), calcium
(p=0.022), and platelet count (p=0.010) were associated with increased
mortality. There was a positive and weak relationship between serum
D-dimer levels and length of hospitalization. Conclusion: Our data imply
that identification and validation of indicators that predict COVID-19
disease progression to improve health outcomes are crucial. Age,
comorbidities, immunological response, radiographic abnormalities,
laboratory markers, and signs of organ dysfunction may all predict poor
outcomes individually or collectively. It is critical to identify
characteristics that predict COVID-19 problems to guide clinical
management, improve patient outcomes, and allocation of limited
resources. Keywords: SARS-Cov-2, COVID-19; severity; prognosis; outcome