ASSESSMENT OF THE PROGNOSTIC SIGNIFICANCE OF LABORATORY PARAMETERS AS FACTORS OF LETHAL OUTCOME IN PATIENTS WITH A NEW CORONAVIRUS INFECTION

Highlights The analysis of laboratory parameters capable of assessing the lethal outcome in patients with COVID-19 was carried out. After that, these parameters were ranked depending on the magnitude of the odds ratio. Abstract Aim. To assess the predictive value of laboratory parameters as factors of lethal outcome in patients with novel coronavirus infection (COVID-19). Methods . The prospective study included 164 patients hospitalized in a monoinfection hospital in the period from November 3, 2020 to January 15, 2021. The diagnosis of COVID-19 was verified by PCR testing for the presence of SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal specimens. Diagnosis, classification of pneumonia based on CT findings, disease severity according to the National Early Warning Score (NEWS), and treatment were conducted according to the “Temporary Guidelines. Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)”, version 9 (10/26/2020). The end of the study was the outcome of hospitalization: discharge or death. The main group consisted of 25 patients with a fatal outcome (Group 1), the 2 nd group (n = 139) consisted of surviving patients. Results. The mortality rate was 15.2%. 56% of the deceased were males, and 44% were females. The average age of the deceased was 72 years [68; 83], compared to 65 years [59,0; 70,5], р < 0,001 in the surviving group. 97.6% of patients were in clear consciousness, while 2.4% were in a state of stupor and soporific. Odds ratio (OR) analysis showed that predictors of fatal outcome in COVID-19 were elevated troponin concentration in blood (OR = 18,38 (95% confidence interval (CI) 6,503–51,97; p < 0,001), D-dimer level > 700 ng/mL (OR = 17,79; 95% CI 6,362–49,77; p < 0,001), procalcitonin (PCT) > 0.28 ng/mL (OR = 7,357; 95% CI 2,840–19,06; p < 0,001), and platelets < 180 × 10 9 /L (OR = 4,76; 95% CI 2,00–11,1; p = 0,001). Monocytes ≥ 6.0% (OR = 0,205; 95% CI 0,067–0,627) were identified as a protective factor. Conclusion. The most significant parameters for predicting prognosis in COVID-19 are troponin, D-dimer, PCT, and platelets. Monitoring these parameters will allow clinicians to identify patients at high risk of death early, requiring more active treatment measures.