Do dynamic changes in haematological and biochemical parameters predict mortality in critically ill COVID-19 patients?

Article type: Research Article

Authors: Jandric, Milka^{a; *} | Zlojutro, Biljana^{a; b} | Momcicevic, Danica^{a; b} | Dragic, Sasa^{a; b} | Kovacevic, Tijana^{a; b} | Djajic, Vlado^{a; b} | Stojiljkovic, Milos P.^c | Loncar-Stojiljkovic, Dragana^b | Skrbic, Ranko^c | Djuric, Dragan M.^d | Kovacevic, Pedja^{a; b}

Affiliations: [a] University Clinical Centre of the Republic of Srpska, Dvanaest beba bb, Banja Luka, Bosnia and Herzegovina | [b] Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina | [c] Centre for Biomedical Research, Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina | [d] Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Correspondence: [*] Corresponding author: Milka Jandric, Medical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, Dvanaest beba bb, Banja Luka 78000, Bosnia and Herzegovina. Tel.: +387 381 51 342 510; E-mail: milka.jandric@kc-bl.com. ORCID: 0000-0003-3814-4635.

Abstract: BACKGROUND: Critically ill COVID-19 patients are usually subjected to clinical, laboratory, and radiological diagnostic procedures resulting in numerous findings. Utilizing these findings as indicators for disease progression or outcome prediction is particularly intriguing. OBJECTIVES: Exploring the significance of dynamic changes in haematological and biochemical parameters in predicting the mortality of critically ill COVID-19 patients. METHODS: The present study was a prospective and observational study involving mechanically ventilated 75 critically ill adult COVID-19 patients with hypoxemic respiratory failure. The collected data included baseline patient characteristics, treatment options, outcome, and laboratory findings at admission and 7 days after. The dynamics of the obtained findings were compared between survivors and non-survivors. RESULTS: The 28-day survival rate was 61.3%. In the group of non-survivors significant dynamic changes were found for C-reactive protein (p= 0.001), interleukin-6 (p< 0.001), lymphocyte (p= 0.003), neutrophil-lymphocyte ratio (p= 0.003), platelets (p< 0.001), haemoglobin (p< 0.001), iron (p= 0.012), and total iron-binding capacity (p< 0.001). Statistically significant changes over time were found for ferritin (p= 0.010), D-dimer (p< 0.001), hs-troponin T (p< 0.002), lactate dehydrogenase (p= 0.001), glucose (p= 0.023), unsaturated iron-binding capacity (p= 0.008), and vitamin D (p< 0.001). CONCLUSION: The dynamic changes in inflammatory, haematological and biochemical parameters can predict disease severity, and outcome.

Keywords: COVID-19, intensive care, outcome, prediction, laboratory parameters

DOI: 10.3233/THC-241006

Journal: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024