The Predictive role of biochemical markers on outcomes of severe COVID-19 patients admitted to Intensive Care Unit

  • Bosa Mirjanić-Azarić University Clinical Centre of the Republic of Srpska, Department of Clinical Biochemistry
  • Ivana Pejic General Hospital Gradiska, Gradiska, Republic of Srpska, Bosnia and Herzegovina
  • Smiljana Mijic Aqualab Laboratory, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Aleksandra Pejcic General Hospital Gradiska, Gradiska, Republic of Srpska, Bosnia and Herzegovina
  • Anita Djurdjevic Svraka General Hospital Gradiska, Gradiska, Republic of Srpska, Bosnia and Herzegovina
  • Dragan Svraka University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
  • Darija Knezevic University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
  • Tatjana Milivojac University of Banja Luka, Medical Faculty, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Natasa Bogavac-Stanojevic University of Belgrade, Faculty of Pharmacy,Belgrade, Serbia
DOI: https://doi.org/10.5937/jomb0-40641
Keywords: COVID-19; neutrophil -to-lymphocyte ratio; systemic inflammation index; D-dimer; magnesium, ferritin.

Abstract


Background: The pandemic of severe acute respiratory syndrome by coronavirus 2 (SARS-CoV-2) is a multi-system disease caused by a diffuse systemic process involving a complex interaction of the inflammatory, immunological and coagulative cascades. This study aims to identify the most effective biomarkers to predict a poor outcome in the intensive care unit patients with severe COVID-19 disease.

Methods: A single-centre retrospective observational study enrolled 69 deceased and 20 recovered patients treated in the Intensive Care Unit of the General Hospital Gradiska in the period from March 1, 2021. until April 1, 2022. We evaluated the leukocytes, lymphocytes, neutrophils, platelets, hemoglobin, neutrophil lymphocyte ratio (NPR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII). In addition, we  evaluated the IL-6, ferritin, CRP, D-dimer, magnesium, bilirubin and lactate dehydrogenase.

 Results: Between deceased and recovered patients on admission to the ICU, there was a significant difference between the following parameters: leukocytes x109/L 11.5 (8.86-14.75) vs 9.4 (5.9-11.9), p =0.026; neutrophils x109/L 10.15 (7.81-12.74) vs 8.60 (4.8-10.3) p=0.022; NLR 15.01 (10.60-24.33) vs 9.45 (5.10-14.90) p=0.02; SII 3712 (2240-6543) vs 1949 (993-3720) p=0.003. The magnesium level increased significantly over time in the group of patients who died, while the hemoglobin level and platelet count decreased. ROC analysis showed the following AUC values: leukocytes 0.774; neutrophils 0.781; NLR 0.786; SII 0.776; D-dimer 0.741and bilrubine 0.713.

Conclusions: In this retrospective study leukocytes, neutrophils, NLR, SII, D-dimer, bilirubin determined at hospital admission had a high value in predicting death among patients with severe COVID-19.

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Published
2023/03/14
Issue
Vol. 42 No. 3 (2023): Journal of Medical Biochemistry
Section
Original paper

Copyright (c) 2023 Bosa Mirjanić-Azarić, Ivana Pejic, Smiljana Mijic, Aleksandra Pejcic, Anita Djurdjevic Svraka, Dragan Svraka, Darija Knezevic, Tatjana Milivojac, Natasa Bogavac-Stanojevic

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