Prognostic Factors and Association of Inflammatory Biomarkers with Severity and Mortality in COVID-19

Abstract

Objectives: To determine prognostic values and association of inflammatory markers with severity and mortality in COVID 19 in a hospital based study. Study design and setting: This retrospective study was conducted from 1st June 2020 to 30th Sept 2020 in Department of Pathology, Qazi Hussain Ahmed Medical Complex, Nowshera and Medical Teaching Institute, Hayatabad Medical complex Peshawar. Methodology: Out of 215, 71 cases were selected that had all relevant information’s on chart available in Blood bank and department of Pathology. Results: Out of 71 patients, 54 (76.1%) were males and 17 (23.9%) females. Thirty five (49.3%) had age>55 years while 31 (43.7%) were in age range 36-55 years. The frequency of the different blood groups were; 25 (35.2%) B+ blood group followed by 19 (26.8%) A+ and 14 (19.7%) O+ blood group. The AUC for d-dimers was (0.725, 95% CI 0.599-0.855) followed by CRP (0.565 95%CI 0.422-0.7.8) and ferritin (0.519 95%CI 0.36-0.679). The median values of d-dimers was significantly higher in the deceased as compared to the survivors (p<0.05- Mann Whitney U test).The CRP and ferritin levels were not significantly different in study groups. There was a significant positive uphill correlation of the hospital stay with higher values of d-dimers (p=0.01, rs= 0.287). Conclusion: D-dimer is a main prognostic factor that predicts mortality in COVID-19 followed by CRP and serum ferritin levels. Male gender and patient with age>60 are at risk of worst outcome under the impact of deranged values of inflammatory mediators. Hospital stay and blood group of patients have no relation with outcome