Retrospective analysis of COVID-19 patients in the region of Eastern Achaia, Greece, in a Primary and Secondary Healthcare Setting. Could initial laboratory findings and age prejudge patients’ outcome?
Main Article Content
Panagiota Xaplanteri
http://orcid.org/0000-0002-4760-4165
Vasileios Zoitopoulos
Vasiliki Diamanti
Athanasia Moutafidi
Panagiota Masoura
Charalampos Potsios
Konstantina Filioti
Angeliki Rapanou
Christina-Panagiota Koutsouri
Zoi Grammenidou
Aimilios Tzoudas
Chara Sakarelou
Tatiana Beqo Rokaj
Katerina Ntzinia
Elsa Kampos Martinez
Georgios Papachristopoulos
Constantinos A Letsas
http://orcid.org/0000-0002-4760-4165
Vasileios Zoitopoulos
Vasiliki Diamanti
Athanasia Moutafidi
Panagiota Masoura
Charalampos Potsios
Konstantina Filioti
Angeliki Rapanou
Christina-Panagiota Koutsouri
Zoi Grammenidou
Aimilios Tzoudas
Chara Sakarelou
Tatiana Beqo Rokaj
Katerina Ntzinia
Elsa Kampos Martinez
Georgios Papachristopoulos
Constantinos A Letsas
Abstract
Background:
Since December 2019 mankind is agonized over the deadly coronavirus disease 2019 (COVID-19) which is due to the novel coronavirus (2019-nCoV) or Severe Acute Respiratory Syndrome Coronavirus-2 (Sars-cov-2).
Methods: In this retrospective study, laboratory findings and demographic features form all confirmed COVID-19 patients who attended the Emergency Department of both branches of our hospital during the first semester of 2021 were collected and analyzed. The working hypothesis was that initial laboratory data at the time the patients seeked medical assistant for the first time, regardless of comorbidities and day of onset of symptoms, can help predict patients’ outcome. Demographic data and laboratory tests were compared between hospitalized and non-hospitalized patients.
Results: Data of 270 patients were collected and analyzed retrospectively. 31 blood measurement parameters performed in both hospital branches were compared between hospitalized and non-hospitalized patients. Of those, WBC count (p=0.016), neutrophil percentage (p<0.001), lymphocyte percentage (p<0.001), platelet count (p=0.041), glucose (p<0.001), urea (p<0.001), creatinine (p<0.001), SGOT (p=0.024), CK (p<0.053), LDH (p<0.001), GGT (p<0.001), sodium (p<0.001), calcium (p<0.001), high sensitivity Troponin I (p<0.001), and ferritin levels (p<0.001), proved statistically significant. Regarding demographic data, age was significantly linked to patients’ survival.
Conclusion: Our data suggest that common initial laboratory findings of COVID-19 patients who seek for the first-time medical assistant regardless of comorbidities and time from onset of symptoms can give clues to the patient outcome. Age is also important for patients’ survival. Especially in a Primary Health Care Setting, common blood parameters like WBC count, neutrophil and lymphocyte percentage, platelet count, glucose, urea, creatinine, SGOT, CK, LDH, GGT, sodium, calcium, high sensitivity Troponin I, and ferritin levels, could be really helpful to predict disease severity.
Keywords:
COVID-19, Sars-cov-2, initial laboratory tests, patient’s outcome, Primary Health Care Setting, Secondary Health Care Setting
Article Details
How to Cite
XAPLANTERI, Panagiota et al.
Retrospective analysis of COVID-19 patients in the region of Eastern Achaia, Greece, in a Primary and Secondary Healthcare Setting. Could initial laboratory findings and age prejudge patients’ outcome?.
Medical Research Archives, [S.l.], v. 10, n. 3, mar. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2724>. Date accessed: 24 dec. 2024.
doi: https://doi.org/10.18103/mra.v10i3.2724.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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20. Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol. 2020;20(6):355-362. https://doi.org/ 10.1038/s41577-020-0331-4.
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22. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020 Jun 25;58(7):1021-1028. doi: 10.1515/cclm-2020-0369.
23. Qu R, Ling Y, Zhang YH, et al. Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020;92(9):1533-41. https://doi.org /10.1002/jmv.25767.
24. Layla KN, Yeasmin S, Azad AB, Chowdhury MU, Sultana N, Muhammad Shazedur Rahman AFS, Rahman MM, Rafa RL. Red blood cell profile in patients with mild, moderate and severe COVID-19. IMC J Med Sci [Internet]. 2021 Aug. 25 [cited 2022 Feb. 4];15(2):26-31. Available from: https://www.banglajol.info/index.php/IMCJMS/article/view/55811
25. Yuan X, Huang W, Ye B, Chen C, Huang R, Wu F, et al. Changes of hematological and immunological parameters in COVID-19 patients. Intern J Hematol. 2020; 112(4): 553-559.
26. Wang C, Deng R, Gou L, Fu Z, Zhang X, Shao F, et al. Preliminary study to identify severe from moderate cases of COVID-19 using combined hematology parameters. Ann Transl Med. 2020; 8(9): 593.
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29. Wynants L, Van Calster B, Collins G S, Riley R D, Heinze G, Schuit E et al. Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal. BMJ 2020; 369:m1328 doi:10.1136/bmj.m1328
30. Komaru Y, Doi K. Does a slight change in serum creatinine matter in coronavirus disease 2019 (COVID-19) patients? Kidney Res Clin Pract. 2021;40(2):177-179. doi: 10.23876/j.krcp.21.108.
31. Post A, Dullaart RPF, Bakker SJL. Sodium status and kidney involvement during COVID-19 infection. Virus Res. 2020; 286:198034. doi: 10.1016/j.virusres.2020.198034.
32. Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24(1):255. doi: 10.1186/s13054-020-02995-3.
33. Akbar MR, Pranata R, Wibowo A, Lim MA, Sihite TA, Martha JW. The prognostic value of elevated creatine kinase to predict poor outcome in patients with COVID-19 - A systematic review and meta-analysis. Diabetes Metab Syndr. 2021;15(2):529-534. doi:10.1016/j.dsx.2021.02.012.
34. De Rosa A, Verrengia EP, Merlo I, et al. Muscle manifestations and CK levels in COVID infection: results of a large cohort of patients inside a Pandemic COVID-19 Area. Acta Myol. 2021;40(1):1-7. Published 2021 Mar 31. doi:10.36185/2532-1900-040.
35. Al Abbasi B, Torres P, Ramos-Tuarez F, Dewaswala N, Abdallah A, Chen K, et al. Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality. Cardiol Res. 2020 Dec;11(6):398-404. doi: 10.14740/cr1159.
36. Dimopoulos G, Sakelliou A, Flevari A, Tzannis K, Giamarellos - Bourboulis J. Ferritin levels in critically ill patients with COVID-19: A marker of outcome? Pneumon. 2021;34(2):5. doi:10.18332/pne/135958.
37. M Hussein A, Taha ZB, Gailan Malek A, Akram Rasul K, Hazim Kasim D, Jalal Ahmed R, Badraden Mohamed U. D-Dimer and Serum ferritin as an Independent Risk Factor for Severity in COVID-19 Patients. Mater Today Proc. 2021 Apr 13. doi: 10.1016/j.matpr.2021.04.009.
38. Hu W, Lv X, Li C, Xu Y, Qi Y, Zhang Z, Li M, Cai F, Liu D, Yue J, Ye M, Chen Q, Shi K. Disorders of sodium balance and its clinical implications in COVID-19 patients: a multicenter retrospective study. Intern Emerg Med. 2021 Jun;16(4):853-862. doi: 10.1007/s11739-020-02515-9.
39. Osman W, Al Fahdi F, Al Salmi I, Al Khalili H, Gokhale A, Khamis F. Serum Calcium and Vitamin D levels: Correlation with severity of COVID-19 in hospitalized patients in Royal Hospital, Oman. Int J Infect Dis. 2021; 107:153-163. doi: 10.1016/j.ijid.2021.04.050.
40. Zhou X, Chen D, Wang L, et al. Low serum calcium: a new, important indicator of COVID-19 patients from mild/moderate to severe/critical [published online ahead of print, 2020 Nov 30]. Biosci Rep. 2020;40(12):BSR20202690. doi:10.1042/BSR20202690.
41. Noori M, Nejadghaderi SA, Sullman MJM, Carson-Chahhoud K, Ardalan M, Kolahi AA, Safiri S. How SARS-CoV-2 might affect potassium balance via impairing epithelial sodium channels? Mol Biol Rep. 2021 Sep;48(9):6655-6661. doi: 10.1007/s11033-021-06642-0. Epub 2021 Aug 15. PMID: 34392451; PMCID: PMC8364628.
42. Bruns JB, Carattino MD, Sheng S, Maarouf AB, Weisz OA, Pilewski JM, Hughey RP, Kleyman TR. Epithelial Na+ channels are fully activated by furin- and prostasin-dependent release of an inhibitory peptide from the gamma-subunit. J Biol Chem. 2007 Mar 2;282(9):6153-60. doi: 10.1074/jbc.M610636200. Epub 2007 Jan 1. PMID: 17199078.
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