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

• 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
• DOI: 10.1155/2021/6689669
• EISSN: 1687-8647
• ISSN: 1687-8639

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.