Evaluating the clinical, radiological, microbiological, biochemical parameters and the treatment response in COVID-19 pneumonia

Year 2022, Volume: 5 Issue: 2, 544 - 551, 15.03.2022

Pınar Mutlu , Arzu Mirici , Uğur Gönlügür , Bilge Oztoprak , Şule Özer , Mustafa Reşorlu , Alper Akçalı , Dilek Ülker Çakır , Cemile Ruşina Doğan

https://doi.org/10.32322/jhsm.1035790

Cited By: 9

Abstract

Aim: The coronavirus disease (COVID-19) has led to over 200,000,000 confirmed cases and over 4,250,000 confirmed deaths worldwide. The present study aimed to explore the links between epidemiological, clinical, biochemical, microbiological, and radiological data and treatment responses of inpatients with COVID-19 pneumonia.
Material and Method: The study included 131 patients hospitalized for COVID-19 pneumonia. Laboratory values ​​such as complete blood count, coagulation profile, AST, LDH, sedimentation, CRP, BUN, creatinine, and D-dimer of the patients were analyzed. The diagnosis of COVID-19 was established by RT-PCR testing of respiratory tract samples. Thoracic CT images were used to determine the severity of involvement in patients. Statistical analyses were performed to establish the differences between the groups and the relationships between the variables.
Results: The most common comorbidities of the patients were hypertension (35.1%) and diabetes mellitus (24.5%). The patients with fever, cough, and dyspnea and who were PCR positive had the highest radiological involvement severity score. The involvement severity scores were negatively correlated with the lymphocyte count, lymphocyte percentage, and albumin levels ​​(p<0.05). Concerning prognostic risk factors, the mean percentages of lymphocytes and eosinophils were significantly higher in the fully recovered patients than those in the intensive care unit (p<0.05).
Conclusion: Our study identified the percentages of lymphocytes and eosinophils as prognostic factors. Identifying the risk factors that predict the possibility of disease progression on admission may contribute to physicians' patient management, increase the therapeutic effect, and reduce the COVID-19 mortality rate.

Keywords

COVID-19, Pneumonia, clinical parameters

References

• Sun P, Lu X, Xu C, et al. Understanding of COVID-19 based on current evidence. J Med Virol 2020; 92: 548-51.
• Zhu N, Zhang D, Wang W, et al. A Novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382: 727-33.
• Health Mo. Ulusal Pandemi Hazırlık Planı Secondary Ulusal Pandemi Hazırlık Planı 2019. https: //hsgm.saglik.gov.tr/tr/bulasicihastaliklar-haberler/ulusal-pandemi-hazirlik-plani.html
• Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet (London, England) 2020; 395: 514-23.
• Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579: 270-73.
• Lillie PJ, Samson A, Li A, et al. Novel coronavirus disease (Covid-19): The first two patients in the UK with person to person transmission. J Infect 2020; 80: 578-606.
• Spina S, Marrazzo F, Migliari M, et al. The response of Milan's Emergency Medical System to the COVID-19 outbreak in Italy. Lancet (London, England) 2020; 395: e49-e50.
• WHO. Coronavirus disease (COVID-19) pandemic. Secondary coronavirus disease (COVID-19) pandemic 2021. https: //www.who.int/emergencies/diseases/novel-coronavirus-2019.
• Chan KS, Lai ST, Chu CM, et al. Treatment of severe acute respiratory syndrome with lopinavir/ritonavir: a multicentre retrospective matched cohort study. Hong Kong Med J=Xianggang yi xue za zhi 2003; 9: 399-406.
• Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenzaa. Clin Infect Dis 2019; 68: e1-e47.
• Hoehl S, Rabenau H, Berger A, et al. Evidence of SARS-CoV-2 Infection in returning travelers from Wuhan, China. N Engl J Med 2020; 382: 1278-80.
• Bakanlığı TCS. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi (Bilim Kurulu Çalışması). Secondary COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi (Bilim Kurulu Çalışması) 2020. https: //covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf.
• Lazzerini M, Putoto G. COVID-19 in Italy: momentous decisions and many uncertainties. Lancet Global Health 2020; 8: e641-e42.
• Liu J, Cao R, Xu M, et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discovery 2020; 6: 16.
• Schrezenmeier E, Dorner T. Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nature Rev Rheumatol 2020; 16: 155-66.
• McCreary EK, Pogue JM. Coronavirus Disease 2019 treatment: a review of early and emerging options. Open Forum Infect Dis 2020; 7: ofaa105.
• Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus disease 2019 (COVID-19) imaging reporting and data system (COVID-RADS) and common lexicon: a proposal based on the imaging data of 37 studies. Eur Radiol 2020; 30: 4930-42.
• Cao J, Tu WJ, Cheng W, et al. Clinical features and short-term outcomes of 102 patients with coronavirus disease 2019 in Wuhan, China. Clin Infect Dis 2020; 71: 748-55.
• Guan W-j, Ni Z-y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England) 2020; 395: 497-506.
• Goyal P, Choi JJ, Pinheiro LC, et al. Clinical characteristics of Covid-19 in New York City. N Engl J Med 2020; 382: 2372-74.
• Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. Jama 2020; 323: 1574-81.
• Livingston E, Bucher K. Coronavirus disease 2019 (COVID-19) in Italy. Jama 2020; 323: 1335.
• Rosenberg ES, Dufort EM, Blog DS, et al. COVID-19 testing, epidemic features, hospital outcomes, and household prevalence, New York State-march 2020. Clin Infect Dis 2020; 71: 1953-59.
• Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 2020; 94: 91-95.
• Rodriguez-Morales AJ, Cardona-Ospina JA, Gutierrez-Ocampo E, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020; 34: 101623.
• Sanyaolu A, Okorie C, Marinkovic A, et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med 2020: 1-8.
• Elezkurtaj S, Greuel S, Ihlow J, et al. Causes of death and comorbidities in hospitalized patients with COVID-19. Scientific Reports 2021; 11: 4263.
• Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet (London, England) 2020; 395: 1763-70.
• Lim S, Bae JH, Kwon H-S, et al. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol 2021; 17: 11-30.
• Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. Jama 2020; 323: 1612-14.
• Bhatraju PK, Ghassemieh BJ, Nichols M, et al. Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. N Engl J Med 2020; 382: 2012-22.
• Roth GA, Emmons-Bell S, Alger HM, et al. Trends in patient characteristics and COVID-19 in-hospital mortality in the United States during the COVID-19 pandemic. JAMA Network Open 2021; 4: e218828-e28.
• Abdulrahman A, Mallah SI, Alqahtani M. COVID-19 viral load not associated with disease severity: findings from a retrospective cohort study. BMC Infect Dis 2021; 21: 688.
• Wagner J, DuPont A, Larson S, et al. Absolute lymphocyte count is a prognostic marker in Covid-19: a retrospective cohort review. Int J Lab Hematol 2020; 42: 761-65.
• Andrés M, Leon-Ramirez J-M, Moreno-Perez O, et al. Fatality and risk features for prognosis in COVID-19 according to the care approach – a retrospective cohort study. PLOS ONE 2021; 16: e0248869.
• Tavakolpour S, Rakhshandehroo T, Wei EX, et al. Lymphopenia during the COVID-19 infection: What it shows and what can be learned. Immunol Lett 2020; 225: 31-32.
• Xie G, Ding F, Han L, et al. The role of peripheral blood eosinophil counts in COVID-19 patients. Allergy 2021; 76: 471-82.
• Yan B, Yang J, Xie Y, et al. Relationship between blood eosinophil levels and COVID-19 mortality. World Allergy Organization J 2021; 14: 100521.
• Kheir M, Saleem F, Wang C, et al. Higher albumin levels on admission predict better prognosis in patients with confirmed COVID-19. Plos One 2021; 16: e0248358.
• Huang J, Cheng A, Kumar R, et al. Hypoalbuminemia predicts the outcome of COVID-19 independent of age and co-morbidity. J Med Virol 2020; 92: 2152-58.