Abstract
This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher's exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes (p = <0.001) and increases in serum creatinine (p = 0.009), LDH (p = 0.057), troponin (p = 0.018), IL-6 (p = 0.053), complement C4 (p = 0.040), and CRP (p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years (p = 0.001). Hypertension (p = 0.064), heart disease (p = 0.048), and COPD (p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission (p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU (p = 0.027), as well as bilateral opacifications (p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.
Highlights
First detected in December 2019, COVID-19 caused by the new coronavirus (SARS-CoV-2) has been considered a pandemic by the World Health Organization (WHO) [1]
Up to the Epidemiological Week Bulletin 38, of September 2020, more than 730,000 cases of ARDS hospitalized in Brazil were reported, 53.2% by COVID-19, with a lethality rate of 34.4% [8]. ese data corroborate to emphasize the importance of establishing clinical, laboratory, and imaging predictors for a worse prognosis in order to assist in the early recognition of patients at risk
Us, the present study aims to assess the risk of severe forms of COVID-19, based on clinical signs, laboratory tests, and computed tomography of patients who were initially in the hospitalization unit
Summary
Received 27 December 2020; Revised 19 May 2021; Accepted 12 June 2021; Published 29 June 2021
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