Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective study
Abstract Coronavirus disease (COVID‐19) caused by SARS‐CoV‐2 has affected over 227 countries. Changes in haematological and biochemical characteristics in patients with COVID‐19 are emerging as important features of the disease. This study aims to identify the pathological findings of COVID‐19 patie...
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | eJHaem |
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| Online Access: | https://doi.org/10.1002/jha2.529 |
| _version_ | 1828716070436864000 |
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| author | Anuja Rasarathnam Terrence Haynes‐Smith Wassif S. Wassif Michael S. Dodd |
| author_facet | Anuja Rasarathnam Terrence Haynes‐Smith Wassif S. Wassif Michael S. Dodd |
| author_sort | Anuja Rasarathnam |
| collection | DOAJ |
| description | Abstract Coronavirus disease (COVID‐19) caused by SARS‐CoV‐2 has affected over 227 countries. Changes in haematological and biochemical characteristics in patients with COVID‐19 are emerging as important features of the disease. This study aims to identify the pathological findings of COVID‐19 patients at Bedford Hospital by analysing laboratory parameters that were identified as significant potential markers of COVID‐19. Patients who were admitted to Bedford Hospital from March–July 2020 and had a positive swab for COVID were selected for this study. Clinical and laboratory data were collected using ICE system. Multiple haematological and biochemistry biomarkers were analysed using univariate and multivariate logistic regression to predict intensive therapy unit (ITU) admission and/or survival based on admission tests. Neutrophil‐to‐lymphocyte ratio (NLR) and C‐reactive protein were elevated in most patients, irrespective of ITU status, representing a common outcome of COVID‐19. This was driven by lymphopenia in 80% and neutrophilia in 42% of all patients. Multivariate logistic regression identified an increase in mortality associated with greater age, elevated NLR, alkaline phosphatase activity and hyperkalaemia. With the area under the receiver operating characteristic (ROC) curve of 0.706 +/− 0.04117, negative predictive value (NPV) 66.7% and positive predictive value (PPV) 64.9%. Analysis also revealed an association between increases in serum albumin and potassium concentrations and decreases in serum calcium, sodium and in prothrombin time, with admission to ITU. The area under the ROC curve of 0.8162 +/− 0.0403, NPV 63.3% and PPV 80.5%. These data suggest that using admission (within 4 days) measurements for haematological and biochemical markers, that we are able to predict outcome, whether that is survival or ITU admission. |
| first_indexed | 2024-03-12T14:07:07Z |
| format | Article |
| id | doaj.art-d79924af7c2a4a41aaa5be832be0a693 |
| institution | Directory Open Access Journal |
| issn | 2688-6146 |
| language | English |
| last_indexed | 2024-03-12T14:07:07Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | eJHaem |
| spelling | doaj.art-d79924af7c2a4a41aaa5be832be0a6932023-08-21T14:06:34ZengWileyeJHaem2688-61462022-08-013366066810.1002/jha2.529Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective studyAnuja Rasarathnam0Terrence Haynes‐Smith1Wassif S. Wassif2Michael S. Dodd3Haematology and Blood Transfusion Bedfordshire Hospitals NHS Foundation Trust Bedford UKHaematology and Blood Transfusion Bedfordshire Hospitals NHS Foundation Trust Bedford UKClinical Biochemistry Bedfordshire Hospitals NHS Foundation Trust Bedford UKSchool of Life Sciences Faculty of Health and Life Sciences Coventry University Coventry UKAbstract Coronavirus disease (COVID‐19) caused by SARS‐CoV‐2 has affected over 227 countries. Changes in haematological and biochemical characteristics in patients with COVID‐19 are emerging as important features of the disease. This study aims to identify the pathological findings of COVID‐19 patients at Bedford Hospital by analysing laboratory parameters that were identified as significant potential markers of COVID‐19. Patients who were admitted to Bedford Hospital from March–July 2020 and had a positive swab for COVID were selected for this study. Clinical and laboratory data were collected using ICE system. Multiple haematological and biochemistry biomarkers were analysed using univariate and multivariate logistic regression to predict intensive therapy unit (ITU) admission and/or survival based on admission tests. Neutrophil‐to‐lymphocyte ratio (NLR) and C‐reactive protein were elevated in most patients, irrespective of ITU status, representing a common outcome of COVID‐19. This was driven by lymphopenia in 80% and neutrophilia in 42% of all patients. Multivariate logistic regression identified an increase in mortality associated with greater age, elevated NLR, alkaline phosphatase activity and hyperkalaemia. With the area under the receiver operating characteristic (ROC) curve of 0.706 +/− 0.04117, negative predictive value (NPV) 66.7% and positive predictive value (PPV) 64.9%. Analysis also revealed an association between increases in serum albumin and potassium concentrations and decreases in serum calcium, sodium and in prothrombin time, with admission to ITU. The area under the ROC curve of 0.8162 +/− 0.0403, NPV 63.3% and PPV 80.5%. These data suggest that using admission (within 4 days) measurements for haematological and biochemical markers, that we are able to predict outcome, whether that is survival or ITU admission.https://doi.org/10.1002/jha2.529biomarkersCOVID‐19hyperkalaemiaITUNLR |
| spellingShingle | Anuja Rasarathnam Terrence Haynes‐Smith Wassif S. Wassif Michael S. Dodd Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective study eJHaem biomarkers COVID‐19 hyperkalaemia ITU NLR |
| title | Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective study |
| title_full | Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective study |
| title_fullStr | Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective study |
| title_full_unstemmed | Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective study |
| title_short | Haematological and biochemical pathology markers for a predictive model for ITU admission and death from COVID‐19: A retrospective study |
| title_sort | haematological and biochemical pathology markers for a predictive model for itu admission and death from covid 19 a retrospective study |
| topic | biomarkers COVID‐19 hyperkalaemia ITU NLR |
| url | https://doi.org/10.1002/jha2.529 |
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