Parameters for Early Detection of Critical Illness in Hospitalized COVID-19 Patients

Document Type : Original Article

Authors

1 Chest Diseases Resident, Chest Diseases Hospital, Zagazig

2 Chest Diseases Department, Faculty of Medicine, Zagazig University, Egypt

Abstract

Background: Monitoring patient outcomes and influencing planning for future service provision requires accurate and trustworthy assessments of the COVID-19 epidemiology in critical care. This research sought to pinpoint specific characteristics in COVID-19 patients upon arrival at the hospital that could indicate their likelihood of becoming critically ill.

Methods: This study is a retrospective cohort study examined the records of 130 COVID-19 patients hospitalized between October 2021 and February 2022. Skilled doctors double-checked the data and extracted the variables needed to predict the risk characteristics of COVID-19 from the validation cohort. The study used the area under the receiver operating characteristic curve (AUC) to evaluate how well the identified risk factors for COVID-19 could predict disease severity.

Results: The most common co-morbidities in all patients were diabetes mellitus, hypertension, cardiac diseases, and COPD. The most frequently reported symptoms across all patients were dyspnea, cough, fatigue, body aches, expectoration, and headache. The CO-RADS assessment revealed a correlation between higher scores, particularly CO-RADS 5, and the severity of COVID-19 pneumonia. Chest CT scans showed significantly more extensive lung involvement in non-survivors compared to survivors. Laboratory results revealed significantly higher levels of lymphopenia, IL-6, and procalcitonin in non-survivors than survivors (p<0.001).

Conclusion: Significant elevations in IL-6, procalcitonin, and ferritin levels were observed in non-survivors, highlighting their potential as biomarkers for disease severity. Non-survivors exhibited greater lung involvement and higher CO-RADS scores, along with elevated levels of IL-6 and procalcitonin with lymphopenia. Additionally, vomiting and diarrhea were markedly higher in non-survivors.

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