Clinical & Laboratory markers as predictors for severity and mortality in COVID-19

Abstract

Backgrounds: COVID-19, a new health challenge, can be diagnosed by many laboratory biomarkers.
Biomarkers became valuable for prognosis; identifying the severity and mortality of the disease in
COVID-19 patients. This study aimed to determine the association of clinical, demographics, and
some laboratory biomarkers (CRP, D-dimer, lymphocyte, and platelet) with the severity and mortality
of COVID-19.
Methods: 104 COVID-19 cases and 34 healthy controls were collected between the 1st of June and
the 1st of November 2020. SARS-CoV-2 infection was confirmed using the real-time RT-PCR
technique. All cases were analyzed for clinical, epidemiological, and laboratory biomarkers. COVID
19 cases were grouped into mild (n=40), moderate (n=32), and severe (n=32) depending on the
severity of the disease. After collecting blood from participants, hematological parameters
(lymphocyte and platelet) and other biomarkers (CRP and D-dimer) were measured by colter and
Cobas c111, respectively.
Results: Age and comorbidities like DM, CVD and smoking showed a significant relation with COVID
19, while ABO, Rh, gender and other comorbidities showed a non-significant relation. Cough and
headache were the most common symptoms expressed by the patients. SpO2 levels were significantly
low in severe and moderate groups. Patients with severe and moderate infections significantly
exhibited higher CRP, D-dimer, and lymphocyte percentage levels than the control group, whereas a
non-significant difference was recorded for each of platelet and absolute lymphocyte counts among
study groups. All studied laboratory biomarkers were significantly higher in non-survivors than in
survivors. A significant correlation was found between D-dimer and other laboratory biomarkers.
Conclusion: Age and most of the studied comorbidities were associated with COVID-19. CRP, D
dimer, and lymphocyte percentage were markers of diseases severity and outcome. All the studied
laboratory biomarkers were associated with mortality.