Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations]
Background COVID-19 disease has spread rapidly worldwide, causing high mortality. Accessible biomarkers capable of early identification of patients at risk of severe form are needed in clinical practice. The aim of the study was to determine the biological markers that predict a critical condition....
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F1000 Research Ltd
2024-11-01
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| author | Jalloul Daghfous Houda Snene Hana Blibech Donia Belkhir Saoussen Miladi Mohamed Aymen Jebali Bechir Louzir Nozha Ben Salah Ahmed Laatar Line Kaabi Nadia Mehiri |
| author_facet | Jalloul Daghfous Houda Snene Hana Blibech Donia Belkhir Saoussen Miladi Mohamed Aymen Jebali Bechir Louzir Nozha Ben Salah Ahmed Laatar Line Kaabi Nadia Mehiri |
| author_sort | Jalloul Daghfous |
| collection | DOAJ |
| description | Background COVID-19 disease has spread rapidly worldwide, causing high mortality. Accessible biomarkers capable of early identification of patients at risk of severe form are needed in clinical practice. The aim of the study was to determine the biological markers that predict a critical condition. Methods Retrospective study including patients with confirmed COVID-19 hospitalized between September 2020 and June 2021. The primary endpoint was progression to critical status within 7 days from admission. We defined two groups: Critical group: Patients who developed a critical condition or died or transferred to the ICU before or at 7th day. Non-critical group: Patients who remained in non-critical respiratory status until 7th day or discharged before or at 7th day. Results Our study included 456 patients, with a sex ratio of 1.32 and an average age of 62 years. At the 7th day of hospitalization, 115 (25.2%) patients were in the critical group and 341 (74.8%) patients were in the non-critical group. The univariate logistic regression indicated that laboratory findings between non-critical and critical groups showed that C-reactive protein (CRP) (p=0.047), D-Dimer (p=0.011), creatinine (0.026), creatine kinase (p=0.039), lactate dehydrogenase (p=0.04), and troponin (p=0.001) were all higher among patients in critical group. However, lymphocyte (p<0.001) and platelet (p<0.001) counts were significantly lower among the critical group. Multivariate logistic regression model, identified four independent risk factors: lymphopenia (OR=2.771, 95%CI=1.482-5.181, p=0.001), Neutrophil to Lymphocyte Ratio (NLR) (OR=2.286, 95%CI=1.461-3.578, p<0.001), thrombocytopenia (OR=1.944, 95%CI=1.092-3.459, p=0.024), and CRP>71.5 (OR=1.598, 95% CI=1.042-2.45, p=0.032) were associated to critical group. Conclusions Our results show the predictive value of lymphopenia, thrombocytopenia, high NLR and CRP levels to evaluate the prognosis of COVID-19 pneumonia. A prognostic score could be proposed for guiding clinical care and improving patient outcomes. |
| format | Article |
| id | doaj-art-e34a37f2e8de4d5dbf6a0cfdb80beb63 |
| institution | OA Journals |
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| language | English |
| publishDate | 2024-11-01 |
| publisher | F1000 Research Ltd |
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| spelling | doaj-art-e34a37f2e8de4d5dbf6a0cfdb80beb632025-08-20T02:21:52ZengF1000 Research LtdF1000Research2046-14022024-11-011310.12688/f1000research.151333.2174176Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations]Jalloul Daghfous0Houda Snene1Hana Blibech2https://orcid.org/0000-0003-4979-8853Donia Belkhir3https://orcid.org/0009-0005-5868-0293Saoussen Miladi4https://orcid.org/0000-0002-3596-8025Mohamed Aymen Jebali5Bechir Louzir6Nozha Ben Salah7Ahmed Laatar8Line Kaabi9Nadia Mehiri10Pulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaRheumatology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaRheumatology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaPulmonology, University Hospital Center Mongi Slim, La Marsa, Tunis, TunisiaBackground COVID-19 disease has spread rapidly worldwide, causing high mortality. Accessible biomarkers capable of early identification of patients at risk of severe form are needed in clinical practice. The aim of the study was to determine the biological markers that predict a critical condition. Methods Retrospective study including patients with confirmed COVID-19 hospitalized between September 2020 and June 2021. The primary endpoint was progression to critical status within 7 days from admission. We defined two groups: Critical group: Patients who developed a critical condition or died or transferred to the ICU before or at 7th day. Non-critical group: Patients who remained in non-critical respiratory status until 7th day or discharged before or at 7th day. Results Our study included 456 patients, with a sex ratio of 1.32 and an average age of 62 years. At the 7th day of hospitalization, 115 (25.2%) patients were in the critical group and 341 (74.8%) patients were in the non-critical group. The univariate logistic regression indicated that laboratory findings between non-critical and critical groups showed that C-reactive protein (CRP) (p=0.047), D-Dimer (p=0.011), creatinine (0.026), creatine kinase (p=0.039), lactate dehydrogenase (p=0.04), and troponin (p=0.001) were all higher among patients in critical group. However, lymphocyte (p<0.001) and platelet (p<0.001) counts were significantly lower among the critical group. Multivariate logistic regression model, identified four independent risk factors: lymphopenia (OR=2.771, 95%CI=1.482-5.181, p=0.001), Neutrophil to Lymphocyte Ratio (NLR) (OR=2.286, 95%CI=1.461-3.578, p<0.001), thrombocytopenia (OR=1.944, 95%CI=1.092-3.459, p=0.024), and CRP>71.5 (OR=1.598, 95% CI=1.042-2.45, p=0.032) were associated to critical group. Conclusions Our results show the predictive value of lymphopenia, thrombocytopenia, high NLR and CRP levels to evaluate the prognosis of COVID-19 pneumonia. A prognostic score could be proposed for guiding clinical care and improving patient outcomes.https://f1000research.com/articles/13-918/v2 COVID-19 Viral pneumonia Critical illness Adult respiratory distress syndrome Biomarkers Prognosiseng |
| spellingShingle | Jalloul Daghfous Houda Snene Hana Blibech Donia Belkhir Saoussen Miladi Mohamed Aymen Jebali Bechir Louzir Nozha Ben Salah Ahmed Laatar Line Kaabi Nadia Mehiri Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations] F1000Research COVID-19 Viral pneumonia Critical illness Adult respiratory distress syndrome Biomarkers Prognosis eng |
| title | Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full | Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_fullStr | Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full_unstemmed | Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_short | Laboratory findings predictive of critical illness in hospitalized COVID-19 patients in Tunisia [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_sort | laboratory findings predictive of critical illness in hospitalized covid 19 patients in tunisia version 2 peer review 1 approved 2 approved with reservations |
| topic | COVID-19 Viral pneumonia Critical illness Adult respiratory distress syndrome Biomarkers Prognosis eng |
| url | https://f1000research.com/articles/13-918/v2 |
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