PREDICTABILITY OF COVID-19 INFECTION AND SEVERITY USING LABORATORY FINDINGS BIOMARKERS IN HOSPITALIZED AND NON-HOSPITALIZED PATIENTS

Mohamed Ebsaim*, Talal Alharari, Hana Fahelbum, Husni Alraheem, Jamila Adeep, Ayiman Ahfeethah, Nihal Anbeeh, Hanadi Eshtab

ABSTRACT

Background: patients infected with SARS-CoV-2 develop potentially life-threatening pathologies involving hyper inflammation, cytokine storm, septic shock complications, coagulation dysfunction, and multiple organ failure. Laboratory biomarkers are effectively used for detecting disease severity and distinguishing between severe and non-severe COVID-19 cases to guide for best therapeutic options. Aim: to predict the incidence and severity of COVID-19 infection through the hematological, inflammatory and coagulation biomarkers in hospitalized and non-hospitalized patients. Materials and Method: in this retrospective cohort study, 114 patients with age ranging between 30-80 years who were diagnosed with COVID-19 positive were selected from Alnaser Isolation Center, Azawia/ Libya. Patients were classified into 49 severe or critically ill patients who admitted to the isolation center, and 65 non-sever group with or without regular symptoms. Results: among hospitalized COVID-19 patients, the levels of WBCs, NEU, CRP, ESR were increased significantly and lymphocytes were decreased significantly (P<0.001) in comparison to their levels in non-hospitalized patients. 10.8 % of non-hospitalized had high D-dimer level whereas, 67.3% of hospitalized patients their D-dimer level was abnormal and increased significantly (P<0.001). Regarding the age groups, only elderly patients (50-79 and ≥ 80 years age groups) showed a significant increase in CRP, ESR and D-dimer levels in both patient groups (P<0.05). Although, the mortality rate among all patients was 20.2%, this percentage increased in hospitalized patients and reached 42.9%. Non-survivors COVID-19 patients developed leukocytosis, neutrophilia and lymphopenia, along with abnormal values of D-dimer, CRP and ESR levels. Conclusion: an elevated serum WBC, NUE, ESR and CRP were associated with start of infection and severity COVID-19 with clearly low level of lymphocyte. Coagulation biomarkers play a crucial role in identifying COVID-19 infection severity and mortality.

Keywords: COVID-19 infection; Severity; Laboratory Biomarkers; Hospitalization; Morality; Survivors and Non-survivors.