Background: COVID-19 is still a global health issue, there is limited evidence in South America regarding laboratory biomarkers associated with severe disease. The objective of our study was to identify hematological and hemostatic changes associated with severe COVID-19.
Methods: A total of 170 hospitalized patients with COVID19 were included in the study, defining their severity according to established criteria. Demographic, clinical, and laboratory (days 1, 3, 7, 15) data were obtained. We performed a statistical analysis, assuming significance with a value of p < 0.05. We analyzed the correlation between severity and biomarkers and established cut-off values for severe patients through ROC curves, estimating Odds Ratio associated with severe disease.
Results: Day 1 was observed significant differences between moderate vs severe patients for leukocytes (WBC), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and D-dimer, establishing cut-off points for each of them. The markers we found associated to risk of severe disease were WBC (OR=3.2396; p = 0.0003), NLR (OR=5.7084; p < 0.0001), PLR (OR=4.4094; p < 0.0001), Neutrophil (OR=4.1193; p < 0.0001), D-dimer (OR=2.7827; p = 0.0124).
Conclusions: The results allow to establish basic laboratory biomarkers associated to severe disease, which could be used as prognostic markers.
Uvod: COVID-19 je i dalje globalno zdravstveno pitanje, u Južnoj Americi postoje ograničeni dokazi u vezi sa laboratorijskim biomarkerima povezanim sa teškom bolešću. Cilj naše studije je bio da se identifikuju hematološke i hemostatske promene povezane sa teškim COVID-19.
Metode: U studiju je uključeno ukupno 170 hospitalizovanih pacijenata sa COVID-19, definišući njihovu težinu prema utvrđenim kriterijumima. Dobijeni su demografski, klinički i laboratorijski (1., 3., 7., 15. dan) podaci. Izvršili smo statističku analizu uz pretpostavku da je značajna vrednost p < 0,05. Analizirali smo korelaciju između težine i biomarkera i utvrdili granične vrednosti za teške pacijente kroz ROC krive, procenjujući Odds Ratio povezan sa teškom bolešću.
Rezultati: Prvi dan primećene su značajne razlike između umerenih i teških pacijenata za leukocite (VBC), odnos neutrofila-limfocita (NLR), odnos trombocita-limfocita (PLR) i Ddimer, uspostavljajući granične tačke za svaki od njih. Markeri za koje smo otkrili da su povezani sa rizikom od teške bolesti bili su VBC (OR=3,2396; p = 0,0003), NLR (OR= 5,7084; p < 0,0001), PLR (OR=4,4094; p < 0,0001), Neutrofil (OR=4,1193; p < 0,0001), D-dimer (OR=2,7827; p = 0,0124).
Zaključak: Rezultati omogućavaju uspostavljanje osnovnih laboratorijskih biomarkera povezanih sa teškim oboljenjem, koji se mogu koristiti kao prognostički markeri.
Keywords: COVID-19; SARS-CoV-2; hematology; laboratory markers; prognosis.
2024 Pablo Letelier, Hugo Delgado, Felipe Garrido, Francisco Quiñones, Martín Andrés San, Loreto Hernández, Paola Garcés, Dina Guzmán-Oyarzo, Rodrigo Boguen, Alfonso Hernandez, Gustavo Medina, Patricia Schwerter, Neftalí Guzmán, published by CEON/CEES.