Abstract
Background/objectivesIn, India coronavirus disease (COVID-19) cases are on the rise in terms of the total number of cases. Findings on clinical and hematological parameters alone carry no significance apart from telling patients present status and hence are diminutive. This study aims to assess the hematological and serum biochemistry parameters and correlate them with the presenting symptoms and severity of disease which can help predict the need for intensive care unit (ICU) care, help in triage, assess the severity of the disease which will help clinicians decide their future course of action and further improve patients clinical outcome. MethodsA total of 200 COVID-19 positive patients were included. Hematological and serum biochemistry parameters were recorded for the patients at the time of admission and categorized as mild, moderate, and severely ill based on clinical status and then admitted into various wards. ResultsTotal leucocyte count (TLC) was significantly different and higher in severely ill patients (13,200 ± 6,999.2) compared to cases presented with mild and moderate symptoms (12,100 ± 6,488.41& 8,788.20 ± 4,954.32, p = 0.001). The mean difference of TLC, Neutrophil% (N%), Lymphocyte% (L%) and Monocyte (M%) was significantly different between mild and moderate symptoms cases (p = 0.030, p = 0.002, p = 0.004 & p = 0.003). Between groups comparison of moderate vs. severely ill cases showed a significant difference in TLC (p = 0.000), N% (p = 0.000), L% (0.000), and L/N ratio (p = 0.002). The serum ionic calcium (Ca), random blood sugar (RBS), C-reactive protein (CRP), fibrinogen, prothrombin (PT), International Normalized Ratio (INR), ferritin, and Lactate Dehydrogenase (LDH) level also differed significantly between mild, moderate and severely ill cases (p = 0.001, p=<0.001, p = 0.002, p=<00.1, p = 0006, p = 0.005, p=<0.001 and p=<0.001) respectively. Comparison of the mild vs. severely ill cases showed a significant difference in urea, fibrinogen, and procalcitonin (PCT) level (p = 0.005, p = 0.000 & p = 0.048) respectively. ConclusionThe preliminary findings of this study suggest hematological and serum biochemistry parameters could be used as a screening tool to identify patients requiring intensive care and thus allowing clinical stratification and triage at the time of presentation.
Highlights
The coronavirus disease (Covid–19) was declared as a pandemic in January 2020 by World Health Organization (WHO)
We have evaluated the hematological and serum biochemistry parameters in a peripheral blood sample of North Indian COVID-19 patients who have gone to the admission to Intensive care units (ICU) {Severe}, High Dependency Units (HDU) {Moderate}, or General Ward (Mild) of King George Medical University (KGMU), Lucknow, Uttar Pradesh
Data of patients for blood count parameters and serum biochemistry parameters of patients admitted to COVID ward, intensive care unit (ICU)/HDU with confirmed positive COVID-19 status by SARSCov– 2 Qualitative Real Time –Polymerase Chain Reaction (RT-PCR) was collected by a treating clinician as per the standard guideline, between May 2020–July 2020 from Chemical Pathology Laboratory, Department of Pathology, KGMU, Lucknow
Summary
The coronavirus disease (Covid–19) was declared as a pandemic in January 2020 by World Health Organization (WHO). It has affected more than 216 countries. More than 43 million cases were diagnosed with 1.1 million death resulted from the disease. The case and death in India are higher affecting 7.9 million with more than 0.1 million death.[1] Early symptoms of the virus infection show common cold symptoms such as fever and swelling of the throat and can develop various conditions, including respiratory, enteric, neurological, and hepatic diseases including Acute Respiratory Distress Syndrome (ARDS), acute cardiac injury, or secondary infection.[2,3] In patients group with underlying medical conditions and elderly patients, the severe respira tory disease may develop causing death.[4] The present COVID-19 situa tion disrupted the health and health services in India in various ways. Studies have found increase in diabetes related problem due to the (http://creativecommons.org/licenses/by/4.0/)
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