Clinical and laboratory markers of the new coronavirus disease SARS-CoV-2 COVID-19 in hospitalized patients

Authors

  • L.R. Shostakovych-Koretskaya  Dnipro State Medical University, V. Vernadsky str., 9, Dnipro, 49044, Ukraine, Ukraine https://orcid.org/0000-0002-3637-8457
  • T.V. Kireyeva Dnipro State Medical University, V. Vernadsky str., 9, Dnipro, 4904, Ukraine https://orcid.org/0000-0002-3556-5031
  • O.P. Shevchenko-Makarenko Dnipro State Medical University, V. Vernadsky str., 9, Dnipro, 4904, Ukraine https://orcid.org/0000-0002-8859-6229
  • M.O. Turchin City Clinical Hospital No. 21 named after prof. Ye.G. Popkova, Kanatna str., 17, Dnipro, 49006, Ukraine https://orcid.org/0000-0001-6421-6407
  • V.I. Chumak City Clinical Hospital No. 21 named after prof. Ye.G. Popkova, Kanatna str., 17, Dnipro, 49006, Ukraine
  • V.O. Chortok City Clinical Hospital No. 21 named after prof. Ye.G. Popkova, Kanatna str., 17, Dnipro, 49006, Ukraine
  • O.M. Drobyshevska Dnipro State Medical University, V. Vernadsky str., 9, Dnipro, 49044; City Clinical Hospital No. 21 named after prof. Ye.G. Popkova, Kanatna str., 17, Dnipro, 49006, Ukraine https://orcid.org/0000-0002-1708-4242

DOI:

https://doi.org/10.26641/2307-0404.2021.4.248085

Keywords:

COVID-19, SARS-CoV-2, 2019-nCoV, pneumonia, antiviral therapy, invasive mechanical ventilation, coronavirus disease

Abstract

The prognostic predictors of an unfavorable course of coronavirus disease (COVID-19) and its complications with manifestations of pneumonia and the need for oxygen support and connection to the invasive mechanical ventilation were studied. Clinical and laboratory associations in hospitalized patients with COVID-19 were evaluated, the possible predictors of connection to the invasive mechanical ventilator in 37 patients were identified. Patients were hospitalized on day 6.65±3.32 of the disease, blood oxygen saturation (SpO2) depended on the severity of the disease and response to therapy. Positive significant correlations between the level of growth stimulating factor (ST2) and D-Dimer, creatine phosphokinase MB fraction (CPK-MB) and D-dimmer, CPK-MB and ST2 were revealed, as well as of ferritin and D-Dimer with ST2. There were no significant associations with troponin. C-reactive protein (CRP) probably correlated with CPK-MB and ferritin. The International Normalized Ratio (INR) indicator had significant correlations with D-dimmer, ST2 and CPK-MB. Cox regression analysis showed that the survival curve has a stepwised nature and the highest risk of deterioration, which requires mechanical ventilation, was noted on the 6th day of illness (95.0% CI = 0.9-1.0, with an average SpO2 level =87.3%). ROC analysis showed the presence of a possible relationship between D-Dimer, ST2 protein, CPK-MB and the risk of developing a critical condition requiring mechanical ventilation in patients. The study showed that COVID-19 disease has a phase nature, when after the first phase of the disease, the pulmonary phase and hypercytokinemia progress in some patients with the development of hypoxia, a decrease in SpO2. Therefore, the identification of markers of disease progression is essential for predicting the course and possible prevention of the development of acute respiratory distress syndrome with the use of invasive mechanical ventilation.

References

Xalafyan AA. [Statistica 6. Statistical data analysis]. Moskva: Binom-Press; 2010. p. 528.

Centers for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed 2019 Novel Coronavirus (2019-nCoV) Infection, Updated February 12, 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html.

Fei Zhou, Ting Yu, Ronghui Du, Guohui Fan, Ying Liu, Zhibo Liu, Jie Xiang, Yeming Wang, Bin Song, Xiaoying Gu, Lulu Guan, Yuan Wei, Hui Li, Xudong Wu, Jiuyang Xu, Shengjin Tu, Yi Zhang, Hua Chen, Bin Cao, Cli¬nical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospec¬tive co¬hort study, The Lancet. 2020;395(10229):1054-62, doi: https://doi.org/10.1016/S0140-6736(20)30566-3

Kim K. et al. Clinical Features of COVID-19 in Uzbekistan. J. Korean Med Sci. 2020 Nov 23;35(45):e404. doi: https://doi.org/10.3346/jkms.2020.35.e404

Chaolin Huang, Yeming Wang, Xingwang Li, Lili Ren, Jianping Zhao, Yi Hu, Li Zhang, Guohui Fan, Jiuyang Xu, Xiaoying Gu, Zhenshun Cheng, Ting Yu, Jiaan Xia, Yuan Wei, Wenjuan Wu, Xuelei Xie, Wen Yin, Hui Li, Min Liu, Yan Xiao, Hong Gao, Li Guo, Jungang Xie, Guangfa Wang, Rongmeng Jiang, Zhancheng Gao, Qi Jin, Jianwei Wang, Bin Cao, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, The Lancet. 2020;395(10223):497-506, ISSN 0140-6736. doi: https://doi.org/10.1016/S0140-6736(20)30183-5

World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 28. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200217-sitrep-28-covid-19.pdf?sfvrsn=a19cf2ad_2.

COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available from: https://www.covid19treatmentguidelines.nih.gov/

Griffiths MJD, McAuley DF, Perkins GD, et al. Guidelines on the management of acute respiratory distress syndrome. BMJ Open Respir. Res. 2019. May 24;6(1):e000420. doi: https://doi.org/10.1136/bmjresp-2019-000420

Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020;323(18):1775-6. doi: https://doi.org/10.1001/jama.2020.4683

Ruscitti P, Berardicurti O, Iagnocco A, Giacomelli R. Cytokine storm syndrome in severe COVID-19. Auto¬immun Rev. 2020 Jul;19(7):102562. Epub 2020 May 3. PMID: 3237400 F. doi: https://doi.org/10.1016/j.autrev.2020.102562

Zhang N, Xie T, Ning W, He R, Zhu B, Mao Y. The Severity of COVID-19 and Its Determinants: A Sys¬tematic Review and Meta-Analysis in China. Sustainability. 2021;13(9):5305. doi: https://doi.org/10.3390/su13095305

Torres Acosta MA, Singer BD. Pathogenesis of COVID-19-induced ARDS: implications for an ageing population. Eur Respir J. 2020 Sep 24;56(3):2002049. PMID: 32747391; PMCID: PMC7397945. doi: https://doi.org/10.1183/13993003.02049-2020

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Published

2021-12-20

How to Cite

1.
Shostakovych-Koretskaya L, Kireyeva T, Shevchenko-Makarenko O, Turchin M, Chumak V, Chortok V, Drobyshevska O. Clinical and laboratory markers of the new coronavirus disease SARS-CoV-2 COVID-19 in hospitalized patients. Med. perspekt. [Internet]. 2021Dec.20 [cited 2024Dec.27];26(4):48-55. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/248085

Issue

Vol. 26 No. 4 (2021)

Section

CLINICAL MEDICINE

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