Značaj inicijalnih kliničko-laboratorijskih parametara kao prognostičkih faktora kod bolesnika sa COVID-19

Biljana Popovska Jovičić; Ivana Raković; Aleksandar  Pavković; Vladan Marković; Sara Petrović; Jagoda Gavrilović; Predrag Čanović; Ružica Radojević Marjanović; Marko Folić

doi:10.2298/VSP220420070P

Biljana Popovska Jovičić University of Kragujevac, Faculty of Medical Sciences, Department of Infectious Diseases
Ivana Raković University of Kragujevac, Faculty of Medical Sciences, Department of Infectious Diseases
Aleksandar Pavković University Clinical Center Kragujevac, Department of Radiological Diagnostics
Vladan Marković University Clinical Center Kragujevac, Department of Radiological Diagnostics
Sara Petrović University of Kragujevac, Faculty of Medical Sciences, Department of Infectious Diseases
Jagoda Gavrilović University of Kragujevac, Faculty of Medical Sciences, Department of Infectious Diseases
Predrag Čanović University of Kragujevac, Faculty of Medical Sciences, Department of Infectious Diseases
Ružica Radojević Marjanović University Clinical Center Kragujevac, Clinic for Infectious Diseases
Marko Folić University Clinical Center Kragujevac, Department of Clinical Pharmacology

DOI: https://doi.org/10.2298/VSP220420070P

Keywords: biološki pokazatelji, telesna masa, indeks, covid-19, smrt, bolest, progresija, hematološki testovi, prognoza, sars-cov-2, bolest, indeks težine, lečenje, ishod

Abstract

Background/Aim. Coronavirus disease 2019 (COVID-19) is a predominantly respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study was to determine whether there were parameters that could predict the development of a severe clinical picture and fatal outcomes in COVID-19 patients. Methods. The study involved 632 patients treated at the Clinic for Infectious Diseases, University Clinical Center Kragujevac, from June 2020 to February 2021. All patients were divided into two groups according to the need for oxygen therapy (Sat 0₂< 94 %). Results. Our results showed that high body mass index (BMI) was singled out as a risk factor for the development of a severe clinical picture (BMI, OR_adjusted = 1.263; 95% CI = 1.117 – 1.427; p < 0.001). Prothrombin time (OR_adjusted = 1.170; 95% CI = 1.004 - 1.364; p = 0.045), as well as low albumin values (OR_adjusted = 0.878; 95% CI = 0.804 - 0.958; p = 0.003), had a predictive significance for the development of a severe clinical picture. Factors that were of predictive importance in patients with fatal outcomes were C-reactive protein (CRP) (OR_adjusted = 1.010; 95% CI = 1.001 – 1.019; p = 0.031), lactate dehydrogenase (LDH) (OR_adjusted = 1.004; 95% CI = 1.001 – 1.006; p = 0.002), and X-ray of the lungs (OR_adjusted = 1.394; 95% CI = 1.170 – 1.661; p < 0.001). Conclusion. The study showed that routine, clinical laboratory parameters can be important in the early detection of patients with a potentially severe clinical picture and fatal outcomes. In patients with a mild clinical picture, CRP, LDH, ferritin, and serum albumin levels may timely indicate disease progression. Monitoring these parameters is of essential importance for the timely clinical assessment of patients with COVID-19 and, thus, the prompt application of adequate therapeutic protocols in the treatment of these patients.

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