Introduction: Laboratory medicine has an important role in the management of COVID-19. The aim of this study was to analyze routinely available blood parameters in intensive care unit COVID-19 patients and to evaluate their prognostic value.
Patients and methods: This is a retrospective, observational, single-center study including consecutive severe COVID-19 patients who were admitted into the intensive care unit of Ben Arous Regional Hospital in Tunisia from 28 September 2020 to 31 May 2021. The end point of the study was either hospital discharge or in-hospital death. We defined two groups based on the outcome: survivors (Group 1) and non-survivors (Group 2). Demographical, clinical, and laboratory data on admission were collected and compared between the two groups. Univariate and multivariate logistic regression analysis were performed to determine the predictive factors for COVID-19 disease mortality.
Results: A total of 150 patients were enrolled. Eighty patients (53.3%) died and 70 (46.7%) survived during the study period. Based on statistical analysis, median age, Simplified Acute Physiology Score (SAPS II) with the serum levels of urea, creatinine, total lactate dehydrogenase (LDH), creatine kinase, procalcitonin and hs-troponin I were significantly higher in non-survivors compared to survivors. On multivariate analysis, LDH activity ≥ 484 U/L (OR=17.979; 95%CI [1.119-2.040]; p = 0.09) and hs-troponin I ≥ 6.55 ng/L (OR=12.492; 95%CI [1.691-92.268]; p = 0.013) independently predicted COVID-19 related mortality.
Conclusion: Total LDH and hs-troponin I were independent predictors of death. However, further clinical investigations with even larger number of patients are needed for the evaluation of other laboratory biomarkers which could aid in assessing the prediction of mortality.
Keywords: COVID-19; intensive care unit; laboratory blood tests; prognosis.
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