Can simple blood markers predict the outcome of coronavirus disease 2019 (COVID-19) infection?

Abstract

Background
Several millions of humans all over the world were affected by the novel coronavirus that emerged in Wuhan, Hubei, China, at the end of December 2019, known as severe acute respiratory syndrome coronavirus 2. The epidemic has gradually spread to 208 countries, leading to the death of more than two million and a half people, and this number is rapidly increasing. The rationale of the current study was to assess the role of some simple blood markers in suspecting the outcome of patients with severe infection.


Patients and methods
A cohort retrospective study was carried out that included critically ill coronavirus disease 2019-infected patients with positive PCR test result who were admitted to the critical care unit within 2 months. Information concerning clinical presentation, laboratory, and radiological findings was collected; moreover, the outcome and the length of critical care stay were documented. Statistical analysis was done, where collected data were compared between survivors and nonsurvivors. Receiver operating characteristic curve was used for the assessment of sensitivity and specificity of blood markers in predicting mortality.


Results
The number of patients included in the present study was 103. Most patients presented with fever and cough, and the main radiological finding was bilateral ground-glass lesions. On comparing both groups, the group that survived had elevated baseline values of PaO2/FiO2 ratio and lymphocyte count. However, the number of neutrophils, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, D-dimer, and serum level of ferritin were lower in this group; nonsurvivors had longer ICU stay. The following parameters were predictors for mortality: older age; increased neutrophil count, NLR, and D-dimer levels; and lower values of PaO2/FiO2 ratio. D-dimer and NLR had the highest sensitivity (81.3 and 87.5%, respectively) with area under the curve of 0.82 and 0.76, respectively.


Conclusion
Simple blood markers are sensitive parameters for suspecting outcome of severe coronavirus disease 2019 infection.