Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-1...

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Bibliographic Details
Published in:Advances in virology Vol. 2021; pp. 1 - 7
Main Authors: Costa, Víctor O., Nicolini, Eveline M., da Costa, Bruna M. A., Teixeira, Fabrício M., Ferreira, Júlia P., Moura, Marcos A., Montessi, Jorge, Campos, Rogério L., Guaraldo, Andrea N., Costa, Patrícia M.
Format: Journal Article
Language:English
Published: New York Hindawi 2021
Hindawi Limited
Subjects:
Age
Calcium-binding protein
Chronic obstructive pulmonary disease
Complement component C4
Computed tomography
Coronary artery disease
Coronaviruses
COVID-19
COVID-19 vaccines
Creatinine
Data analysis
Electronic health records
Electronic medical records
Heart diseases
Hospitalization
Hospitals
Hypertension
Interleukin 6
Laboratories
Lymphocytes
Medical records
Medical research
Oxygen saturation
Parenchyma
Patients
Pleural effusion
Pneumonia
Sepsis
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
Troponin
Vital signs
Brazil
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Summary:This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes (p = <0.001) and increases in serum creatinine (p = 0.009), LDH (p = 0.057), troponin (p = 0.018), IL-6 (p = 0.053), complement C4 (p = 0.040), and CRP (p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years (p = 0.001). Hypertension (p = 0.064), heart disease (p = 0.048), and COPD (p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission (p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU (p = 0.027), as well as bilateral opacifications (p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.
Bibliography:Academic Editor: Jay C. Brown
ISSN:1687-8639
1687-8647
DOI:10.1155/2021/6689669