DO LABORATORY BIOMARKERS PREDICT SURVIVAL IN SEVERE COVID-19? A CROSS-SECTIONAL STUDY

Authors

  • Sher Bahadur
  • Fawad Rahim
  • Said Amin Hayatabad Medical Complex / Khyber Girls Medical College, Peshawar.
  • Mohammad Noor
  • Huma Gul
  • Afsheen Mahmood
  • Muhammad Usman
  • Raza Ullah
  • Muhammad Asif Khan
  • Khalid Shahab

DOI:

https://doi.org/10.55519/JAMC-04-S4-9007

Abstract

Background: This study aims to compare lymphocyte count, C-reactive protein (CRP), ferritin, Lactate Dehydrogenase (LDH) and D-dimer among survivors and non-survivors of severe COVID-19. Methods: This retrospective cross-sectional analytical study included 69 patients for whom a record of the biomarkers and survival status was available. Baseline and peak values were selected for serum CRP, ferritin, LDH and D-Dimer. Baseline and trough lymphocyte counts were selected. Data were analyzed using SPSS version 21. Mean and standard deviation were used to compare the biomarkers with paired t-test. p-value <0.05 was taken as significant. Results: The mean age of the study population was 55.5±9.1 years and 50 (72.5%) were male. Among survivors, the increase in CRP level was not significant (from 15.80±9.8 mg/dl to 17.87±8.4 mg/dl, p=0.45) while it was significant in non-survivors (from 16.68±10.90 mg/dl to 20.77±12.69 mg/dl, p=0.04). There was no significant rise in LDH levels in survivors (from 829.59±499 U/L to 1018.6±468 U/L, p=0.20) while it increased significantly in non-survivors (from 816.2±443.08 U/L to 1056.61±480.54 U/L, p=0.003). The decrease in lymphocyte count and increase in D-Dimers in both the groups was significant (p=0.001). There was no significant elevation in ferritin in both the groups (p>0.05). Conclusion: In severe COVID-19 patients, serum CRP and LDH can be used for risk stratification and predicting survival. Lymphopenia, increase in serum ferritin and D-dimers may not predict survival.

References

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054-62.

WHO. Virtual press conference on COVID-19 - 11 March 2020. [Internet]. [cited 2020 Sep 6]. Available from: https://www.who.int/docs/default-source/coronaviruse/transcripts/who-audio-emergencies-coronavirus-press-conference-full-and-final-11mar2020.pdf?sfvrsn=cb432bb3_2

WHO. WHO Coronavirus Disease (COVID-19) Dashboard [Internet]. [cited 2020 Sep 12]. Available from: https://covid19.who.int/?gclid=CjwKCAjw1K75BRAEEiwAd41h1OSTbAOdEK4-U4n0tVe2nMkkHxqRC6zkC9JS0YUa8s5mvPTG2sXQhxoCFsgQAvD_BwE

COVID Portal Pakistan [Internet]. [cited 2020 Sep 12]. Available from: http://covid.gov.pk/

Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci 2020;57(6):1-11.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382(18):1708-20.

Feng X, Li S, Sun Q, Zhu J, Chen B, Xiong M, et al. Immune-inflammatory parameters in COVID-19 cases: A systematic review and meta-analysis. Front Med 2020;7:1-14.

Chen W, Zheng KI, Liu S, Yan Z, Xu C, Qiao Z. Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob 2020;19:1-7.

Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol 2020;95(6):E131-4.

Ji W, Bishnu G, Shen X, Cai Z. Analysis clinical features of COVID-19 infection in secondary epidemic area and report potential biomarkers in evaluation. MedRxiv 2020;1-10.

Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol 2020;20(6):363-74.

Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020;130(5):2620-9.

Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy Eur J Allergy Clin Immunol 2020;75(7):1730-41.

11pc Pakistanis have developed protective immunity: study. [Internet]. [cited 2020 Aug 25]. Available from: https://www.dawn.com/news/1575607/11pc-pakistanis-have-developed-protective-immunity-study: (accessed 08/25/2020)

WHO. Clinical management of severe acute respiratory infection when COVID-19 is suspected (v1.2). 2020;1-21. [Internet]. [cited 2020 Sep 12]. Available from: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected

Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): Systematic review and meta-analysis. J Intensive Care 2020;8(1):1-10.

Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther 2020;5(1):16-8.

Fischer K, Hoffmann P, Voelkl S, Meidenbauer N, Ammer J, Edinger M, et al. Inhibitory effect of tumor cell-derived lactic acid on human T cells. Blood 2007;109(9):3812-9.

Li Q, Ding X, Xia G, Chen HG, Chen F, Geng Z, et al. Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: A retrospective case-control study. EClinicalMedicine 2020;23:100375.

Wang L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect 2020;50(4):332-4.

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med 2020;180(7):934-43.

Wu MY, Yao L, Wang Y, Zhu XY, Wang XF, Tang PJ, et al. Clinical evaluation of potential usefulness of serum lactate dehydrogenase (LDH) in 2019 novel coronavirus (COVID-19) pneumonia. Respir Res 2020;21(1):171.

Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol 2020;95(7):834-47.

Polimeni A, Leo I, Spaccarotella C, Mongiardo A, Sorrentino S, Sabatino J, et al. Prognostic Impact of Coagulopathy in Patients with COVID-19: a Meta-analysis of 35 Studies and 6427 Patients [Internet]. 2020. [cited 2020 Jun 2]. Available from: https://www.researchgate.net/publication/341590482_Prognostic_Impact_of_Coagulopathy_in_Patients_with_COVID-19_a_Meta-analysis_of_35_Studies_and_6427_Patients

Downloads

Published

2022-10-11

How to Cite

Bahadur, S., Rahim, F., Amin, S., Noor, M., Gul, H., Mahmood, A., … Shahab, K. (2022). DO LABORATORY BIOMARKERS PREDICT SURVIVAL IN SEVERE COVID-19? A CROSS-SECTIONAL STUDY. Journal of Ayub Medical College Abbottabad, 34(4(SUPPL 1), 919–922. https://doi.org/10.55519/JAMC-04-S4-9007