Laboratory tests and clinical outcome in hospitalized patients for COVID-19

Abstract

 Objective: To identify laboratory results associated with the risk of death in patients hospitalized for COVID-19. Material and methods: retrospective cohort study of patients admitted for COVID-19 at the Hospital Nacional EsSalud Guillermo Almenara Irigoyen in Lima, between March 21 and May 12, 2020. The laboratory tests included in the study were those of hospital admission. A Cox analysis was done to determine factors associated with death. Results: a total of 433 patients were included: 253 cases (58%) with positive RT-PCR and 180 cases (42%) with reactive rapid antibody test. And, 55% (240/433) and 59% (256/433) had leukocytosis and relative lymphopenia (≤10%), respectively. 56% (49/87) had D-dimer greater than two mg/L. However, higher than normal values were presented in 39% (152/393) for urea and 19% (77/397) for creatinine, as well as 73% (228/313) for aspartate aminotransferase and 62% (193/310) for alanine aminotransferase. On the other hand, 54% (180/336) had C-reactive protein greater than 150 mg/L, 42% (108/258) lactate dehydrogenase greater than 450 U/L and 57% (52/91) ferritin greater than one thousand ng/mL. Subsequently, leukocytosis (HRa 2.72; IC955; 1.12-6.60), less than three hundred thousand platelets per mm3 (HRa 2.36; CI95%; 1.23-4.52), and increases in normal creatinine values (HRa 3.03; CI95%; 1.41-6.48) as lactate dehydrogenase above 450 U/L (HRa 2.41; CI95%; 1.29-4.49) were independently associated with death. Conclusion: the death of hospitalized patients by COVID-19 was independently associated with leukocytosis, less than three hundred thousand platelets per mm3, creatinine above normal and lactate dehydrogenase greater than 450 U /L.