CLINICAL AND LABORATORY PREDICTORS OF SEVERE COVID-19 IN MEN AND WOMEN OF DIFFERENT AGE GROUPS

Abstract

The large amount of papers on studying severe COVID-19 predictors have been published so far, but unfortunately the identified criteria are not universal for different regions of Russia and for the whole world. Therefore, a decision was made to apply routine research methods and compare the criteria previously proposed by other researchers with the criteria identified by us in patients living in Astrakhan Region. The study aimed at searching for and analyzing clinical and laboratory predictors to improve prediction of severe COVID-19 in men and women of different age groups. Materials and methods. Medical records of 361 patients were used as clinical material to conduct a retrospective study. Four groups with sex and age differencies were formed to verify the factors aggravating the course of COVID-19. Examination was performed according to Version 9 of the Temporary Guidelines for Prevention, Diagnosis and Treatment of the Novel Coronavirus Infection (COVID-19). Results. Clinical evidence on admission included unspecific complaints typical of other acute respiratory diseases – generalized weakness, temperature rise over 37.5° C, dyspnea, dry cough, and compressing pain. The spectrum of comorbid diseases includes hypertension, congestive heart failure, coronary heart disease, diabetes mellitus, and obesity. Conclusions. Delayed hospitalization of patients from the day of disease onset due to nonspecific COVID-19 symptoms is one of the unfavorable clinical predictors. Comorbidities that aggravate the course of COVID-19 are consistent with the comorbid conditions identified by other researchers [1,2]. High levels of procalcitonin, D-dimer, brain natriuretic peptide, lactate dehydrogenase and blood creatinine were identified as the most significant predictors of severe COVID-19 on admission, which is also consistent with the findings of other authors. Laboratory parameters like alanine transaminase > 45 u/l and aspartate transaminase > 55 u/l can be used for male patients aged 55 and older, while an increased leukocyte count > 7.4 ×109/l and C-reactive protein > 82 g/l – for female patients aged 55 and older.