kamila Hashemzadeh; Ali Esparham; Farnoosh Ebrahimzadeh; Konstantinos Triantafyllias; Zahra Mirfeizi; Maryam Sahebari; Mohammad Hassan J Joker; Mandana Khodashahi; Masoumeh Salari; Bita Abbasi; Delaram Omidvar; Mahtab Ghaemi; Hassan Mehrad-Majd
Abstract
Introduction: Health care systems all over the world face numerous challenges as a result of the rapid spread of the COVID-19 virus that has resulted in increased mortality rates. About 40% of ICU-admitted COVID-19 patients were not severely ill at the time of admission. Thus, by using appropriate ICU ...
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Introduction: Health care systems all over the world face numerous challenges as a result of the rapid spread of the COVID-19 virus that has resulted in increased mortality rates. About 40% of ICU-admitted COVID-19 patients were not severely ill at the time of admission. Thus, by using appropriate ICU admission predictors, clinicians can identify potential critical patients early on. It can also result in suitable resource allocation and consideration for these patients. Therefore, the current study was done with the aim of identifying clinical characteristics and laboratory data that could predict ICU admission in cases with COVID-19.Methods: This two-center retrospective observational study was done in Imam Reza and Ghaem Hospitals, Mashhad, Iran. Overall, 334 COVID-19 patients who referred to these hospitals from February to May 2020 were enrolled in this study. The participants were separated into two groups according to ICU admission status. All demographic, clinical, and paraclinical information were extracted from the medical records of the patients. Results: The present study composed of 88 ICU and 246 non-ICU-admitted COVID-19 patients. No significant differences were found in age between the two groups of patients (P=0.154). Multivariate regression analysis revealed that higher levels of CRP (OR=1.01, 95%CI 1.001-1.010, P=0.016), WBC (OR=1.11, 95% CI 1.01-1.22, P=0.03), and HRCT scores (OR=1.08, 95%CI=1.01-1.16, P=0.037) were linked to higher odds of ICU admission.Conclusion: This study suggests that higher levels of CRP, WBC, and LDH, as well as the HRCT score at the time of admission, were potential independent predictors of ICU admission during inpatient treatment in COVID-19 patients.
Mohammad Reza Rouhbakhsh Zahmatkesh; Saman Soleimanpour; Zahra Mirfeizi; Nasrin Milani
Abstract
The coronavirus disease 2019 (COVID-19), which has spread to many countries, is so severe that it progresses rapidly to acute respiratory failure. Therefore, in our paper, we aimed to describe and evaluate the most practical laboratory pro-inflammatory factors to predict the course of severe COVID-19 ...
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The coronavirus disease 2019 (COVID-19), which has spread to many countries, is so severe that it progresses rapidly to acute respiratory failure. Therefore, in our paper, we aimed to describe and evaluate the most practical laboratory pro-inflammatory factors to predict the course of severe COVID-19 cases.Given the physiopathology of COVID-19 and the consequent immune system hyperactivity, we started to investigate the background pathology of these occurrences aiming to find the prognostic laboratory factors in COVID-19 cases. All reviews focused on the potential cellular and molecular mechanisms causing the cytokine storm in viral diseases, and several studies approved applicable laboratory parameters for COVID-19 patients. Based on our data, increased CRP level, LDH, serum ferritin, creatine kinase (CK), higher D-dimer and FDP levels, IL-6, cardiac troponin I and longer PT can be potential markers for predicting the course of infection; particularly, D-dimer, which was elevated to five times the original count in severe cases. Apart from that, the severe cases showed lymphopenia, neutrophilia, thrombocytopenia, and prolonged PTT. However, there was contradictory evidence about AST, ALT, BUN, and serum creatinine.The major cause of COVID-19 in critical patients was a cytokine storm; therefore, prognostic factors in the cytokine storm can also predict the prognosis of COVID-19. Thus, severe cases can be solved by early detection of these laboratory parameters.