Clinical-laboratory Characteristics Predictive of COVID-19 Severity: a Prospective Hospital Cohort, in Pernambuco, Northeast Brazil

Overview

Journal Braz J Microbiol

Specialty Microbiology

Date 2024 Jul 2

PMID 38955981

Authors

Carlos Brito

Carolline de Araujo Mariz

Rafael Freitas de Oliveira Franca

Edmundo Pessoa Lopes

Laura Emanuelle Silva

Roberto Lins Neto

Isabelle Freire Viana

Ulisses Montarroyos

Claudio Duarte

Heloisa Ramos Lacerda

Pamella de Brito Ximenes

Rafael Cabral de Oliveira Viana

Rayssa Gatis Damorim Lima

Ananda Paiva Santos Carneiro

Cynthia Braga

Affiliations

Soon will be listed here.

Abstract

Objective: To describe the clinical-laboratory profile and analyze the factors associated with the severity of COVID-19.

Methods: A prospective cohort study involving patients with COVID-19 admitted to a tertiary hospital in Recife, Brazil. All cases were confirmed by RT-PCR and classified according to severity criteria. A descriptive statistical analysis of the population's characteristics was conducted. Risk factors associated with the outcome of the case according to severity were analyzed by calculating the odds ratio (OR) using the general equation estimation (GEE) model.

Results: Among the 75 cases included, 64% were female, and 62.7% were aged 65 years or older. The median length of stay was 9 days (6 - 14). Hypertension (65.3%) and Diabetes Mellitus (36%) were the most frequent comorbidities. Severe forms of COVID-19 constituted 41.3% of the sample. The factors associated with severity were a history of asthma (OR=4.58, 95%CI:1.13 - 18.7), report of anorexia (OR=1, 12, 95%CI:1.01-1.24), and laboratory changes that included elevated platelets (OR=1.00, 95% CI:1.00-1.01), elevated D'Dimer (OR=1, 26, 95% CI:1.04-1.52), elevated aspartate aminotransferase (OR=1.00, 95% CI:1.00-1.01), and gamma-glutamyl transferase (OR=1.22, IC95 %:0.98-1.51), hypernatremia (OR=1.31, 95%CI:1.12-1.52), and hyperkalemia (OR=1.21, 95% CI:1.04-1.41).

Conclusion: Multisystemic involvement with a tendency for thrombophilia, electrolyte disturbances, and hepatic aggression, reflected by laboratory changes, were factors associated with the severity of COVID-19.

References

Brito C, Barros F, Lopes E . Mechanisms and consequences of COVID-19 associated liver injury: What can we affirm?. World J Hepatol. 2020; 12(8):413-422. PMC: 7475779. DOI: 10.4254/wjh.v12.i8.413. View

Garcia-Gallo E, Merson L, Kennon K, Kelly S, Citarella B, Fryer D . ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19. Sci Data. 2022; 9(1):454. PMC: 9339000. DOI: 10.1038/s41597-022-01534-9. View

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J . Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382(18):1708-1720. PMC: 7092819. DOI: 10.1056/NEJMoa2002032. View

Acuti Martellucci C, Flacco M, Soldato G, Di Martino G, Carota R, Caponetti A . Effectiveness of COVID-19 Vaccines in the General Population of an Italian Region before and during the Omicron Wave. Vaccines (Basel). 2022; 10(5). PMC: 9146679. DOI: 10.3390/vaccines10050662. View

Cilloniz C, Motos A, Pericas J, Castaneda T, Gabarrus A, Ferrer R . Risk factors associated with mortality among elderly patients with COVID-19: Data from 55 intensive care units in Spain. Pulmonology. 2023; 29(5):362-374. PMC: 9935281. DOI: 10.1016/j.pulmoe.2023.01.007. View

Carvalho V, Pontes J, Neto D, Borges C, Campos G, Ribeiro H . Mortality and Associated Factors in Patients with COVID-19: Cross-Sectional Study. Vaccines (Basel). 2023; 11(1). PMC: 9863925. DOI: 10.3390/vaccines11010071. View

Labenz C, Toenges G, Worns M, Sprinzl M, Galle P, Schattenberg J . Liver injury in patients with severe acute respiratory syndrome coronavirus-2 infection: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2020; 33(9):1194-1200. DOI: 10.1097/MEG.0000000000001827. View

Mohammed S, Eid K, Anyiam F, Wadaaallah H, Muhamed M, Morsi M . Liver injury with COVID-19: laboratory and histopathological outcome-systematic review and meta-analysis. Egypt Liver J. 2022; 12(1):9. PMC: 8781706. DOI: 10.1186/s43066-022-00171-6. View

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q . Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94:91-95. PMC: 7194638. DOI: 10.1016/j.ijid.2020.03.017. View

10.

Qu R, Ling Y, Zhang Y, Wei L, Chen X, Li X . Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020; 92(9):1533-1541. PMC: 7228291. DOI: 10.1002/jmv.25767. View

11.

Rodriguez-Morales A, Gallego V, Escalera-Antezana J, Mendez C, Zambrano L, Franco-Paredes C . COVID-19 in Latin America: The implications of the first confirmed case in Brazil. Travel Med Infect Dis. 2020; 35:101613. PMC: 7129040. DOI: 10.1016/j.tmaid.2020.101613. View

12.

Sansone N, Pereira L, Boschiero M, Valencise F, Fraga A, Marson F . Characterization of Clinical Features of Hospitalized Patients Due to the SARS-CoV-2 Infection in the Absence of Comorbidities Regarding the Sex: An Epidemiological Study of the First Year of the Pandemic in Brazil. Int J Environ Res Public Health. 2022; 19(15). PMC: 9331852. DOI: 10.3390/ijerph19158895. View

13.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J . Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-1069. PMC: 7042881. DOI: 10.1001/jama.2020.1585. View

14.

Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J . Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020; 81(2):e16-e25. PMC: 7177098. DOI: 10.1016/j.jinf.2020.04.021. View

15.

Rodriguez-Morales A, Cardona-Ospina J, Gutierrez-Ocampo E, Villamizar-Pena R, Holguin-Rivera Y, Escalera-Antezana J . Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020; 34:101623. PMC: 7102608. DOI: 10.1016/j.tmaid.2020.101623. View

16.

Martins M, Blais R, de Miranda N . [Evaluation of the Charlson comorbidity index among inpatients in Ribeirão Preto, São Paulo State, Brazil]. Cad Saude Publica. 2008; 24(3):643-52. DOI: 10.1590/s0102-311x2008000300018. View

17.

Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H . Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta. 2020; 510:475-482. PMC: 7426219. DOI: 10.1016/j.cca.2020.08.019. View

18.

Turcotte J, Meisenberg B, MacDonald J, Menon N, Fowler M, West M . Risk factors for severe illness in hospitalized Covid-19 patients at a regional hospital. PLoS One. 2020; 15(8):e0237558. PMC: 7423129. DOI: 10.1371/journal.pone.0237558. View

19.

Kim H, Hwang H, Hong H, Yim J, Lee J . A systematic review and meta-analysis of regional risk factors for critical outcomes of COVID-19 during early phase of the pandemic. Sci Rep. 2021; 11(1):9784. PMC: 8105319. DOI: 10.1038/s41598-021-89182-8. View

20.

Johnson A, Amin A, Ali A, Hoots B, Cadwell B, Arora S . COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence - 25 U.S. Jurisdictions, April 4-December 25, 2021. MMWR Morb Mortal Wkly Rep. 2022; 71(4):132-138. PMC: 9351531. DOI: 10.15585/mmwr.mm7104e2. View