Biochemical Markers as Predictors of Coronavirus Disease-2019 Severity and Intensive Care Unit Admission: A Retrospective Study in Saudi Arabia.

BACKGROUND AND

aimsCoronavirus disease-2019 (COVID-19) is an emerging infectious disease that can present with a wide range of symptoms and lead to increased mortality by causing extreme respiratory failure, multiple organ dysfunction, and death. Several biochemical markers have been proposed to predicting the severity of COVID-19 and the consequent need for intensive care unit (ICU) admission. This study provides insight into the role of different laboratory parameters as a minimally invasive method in the prediction of COVID-19 severity and the need for ICU admission. MATERIALS AND

methodsThis retrospective observational study included all patients with positive real-time polymerase chain reaction (RT-PCR) results for COVID-19 who were hospitalized at the Ministry of Health South Al-Qunfudah General Hospital between March and September 30, 2020. Laboratory parameters (white blood cell [WBC] count, lymphocytes, lactate dehydrogenase [LDH], and erythrocyte sedimentation rate [ESR]) levels were evaluated.

resultsBiochemical parameters were analyzed in 342 COVID-19 patients, comprising 206 males and 136 females, with a mean age of 54 years. 97 patients had critical illnesses, while 245 had noncritical illnesses. Critical illness was defined as a condition that required intensive care or that resulted in death. Noncritical illnesses did not require intensive care, resulting in recovery. High LDH levels were significantly associated with critical COVID-19 cases compared with noncritical cases. WBC and lymphocyte parameter analyses included 287 patients. Of these, 170 were male and 117 were female. These analyses were conducted under severe conditions. The mean WBC count was significantly higher in the critical cases than in the noncritical cases (11.15 vs. 6.96, P = 0.001). The mean lymphocyte count (LC) was significantly lower in critical cases than in noncritical cases (1.11 vs. 1.89, P = 0.007). Age and sex were not significantly associated with the disease severity or mortality. The ESR parameter analysis included 161 patients. Based on the severity of the condition, there were 63 women. These patients' critical outcomes included 15 patients, while the noncritical outcomes included 146 patients; however, it was not significant to compare critical and noncritical patients, indicating that these parameters cannot be used as biomarkers to predict the severity of COVID-19.

conclusionsWe studied the effects of various biochemical markers on the prognosis of COVID-19. Our findings concluded critical COVID-19 is associated with significantly increased WBCs counts, LDH, and decreased LC. The ESR is not a potential biomarker for predicting the severity of COVID-19. It is important to note that the use of biochemical markers to assess severity has been reported in the literature, and further research is required to validate their effectiveness.