CT-365: The Evaluation of Haematological and Biochemistry Parameters in COVID-19 Patients as a Predictive Factor for Unfavourable Evolution

CONTEXT: Coronavirus disease 2019 (COVID-19) is a highly infectious disease. Severity of this disease is associated with comorbidities present (hypertension, obesity, pulmonary disease) or with age. OBJECTIVE: In this study, we evaluate haematological and biochemistry parameters in order to obtain indications for unfavourable evolution of the patient. DESIGN AND SETTING: We performed a prospective study that included all patients admitted in our hospital in Hematology, Pneumology, and ICU at Department Colentina Clinical Hospital during April and May 2020. PATIENTS OR OTHER PARTICIPANTS: The study group included 80 patients that was split into ICU and non-ICU patients. All patients were SARS-CoV-2-positive by molecular test. The distribution according to gender was: 47 male with median age: 73 (min 35, max 88) and 33 female with median age: 50 (min 17, max 84). RESULTS: Age is an important risk factor for the severity, as the median age of patients admitted in ICU was 73 (min 43, max 88) compared with non-ICU patients 41 (min 17, max 64), p=0.00004. Comorbidities associated were important but were present in both groups. In ICU patients, we obtained lower level of lymphocytes compared with non ICU group median: 0.87× 103/L (min 0.09 × 103/L max 7.04 × 103/L) vs 2.17 × 103/L (min 0.19 × 103/L max 3.28 × 103/L), p=0.01. There are no significant differences between groups for the rest of haematological parameters. The biochemistry markers ferritin, AST, ALT, LDH, and D Dimers are important in evaluation of COVID-19 patients; there are statistical differences between ICU and non ICU patients (median value: LDH 405.5 UI/l vs 215 U/l, p=0.001; ferritin 1275 ng/ml vs. 161 ng/ml, p=0.002; D Dimers 2.61 mg/ml FEU vs 0.39 mg/ml FEU, p=0.002; AST 70.9 U/l vs. 19.9 U/l, p=0.0003; ALT 50.05 U/l vs. 18.5 U/l, p=0.009). The ICU patients with unfavourable evolution had a higher level of D-Dimers at the admission in hospital compared with ICU patients who was discharged from the hospital (3.42 mg/ml FEU vs 1.09 mg/ml FEU, p=0.01). We did not obtain statistical significance between ICU groups for all haematological and biochemistry parameters. CONCLUSIONS: We conclude that lymphocyte count, LDH, AST, ALT, and ferritin at the time of hospital admission is important to evaluate in COVID-19 patient in order to expect a severe evolution of the disease. D-Dimer should be an important parameter to evaluate for all COVID-19 patients. Anti-thrombotic therapy is important to be introduced in COVID-19 patients.