Abstract
AimTo identify laboratory biomarkers that predict disease severity and outcome among COVID-19 patients admitted to the Millennium COVID-19 Care Center in Ethiopia.MethodsA retrospective cohort study was conducted among 429 COVID-19 patients who were on follow up from July to October 2020. Data was described using frequency tables. Robust Poisson regression model was used to identify predictors of COVID-19 severity where adjusted relative risk (ARR), P-value and 95 CI for ARR were used to test significance. Binary Logistic regression model was used to assess the presence of statistically significant association between the explanatory variables and COVID-19 outcome where adjusted odds ratio (AOR), P-value and 95%CI for AOR were used for testing significance.ResultsAmong the 429 patients studied, 182 (42.4%) had Severe disease at admission and the rest 247 (57.6%) had Non-severe disease. Regarding disease outcome, 45 (10.5%) died and 384 (89.5%) were discharged alive. Age group (ARR = 1.779, 95%CI = 1.405–2.252, p-value <0.0001), Neutrophil to Lymphocyte ratio (NLR) (ARR = 4.769, 95%CI = 2.419–9.402 p-value <0.0001), Serum glutamic oxaloacetic transaminase (SGOT) (ARR = 1.358, 95%CI = 1.109–1.662 p-value = 0.003), Sodium (ARR = 1.321, 95%CI = 1.091–1.600 p-value = 0.004) and Potassium (ARR = 1.269, 95%CI = 1.059–1.521 p-value = 0.010) were found to be significant predictors of COVID-19 severity.The following factors were significantly associated with COVID-19 outcome; age group (AOR = 2.767, 95%CI = 1.099–6.067, p-value = 0.031), white blood cell count (WBC) (AOR = 4.253, 95%CI = 1.918–9.429, p-value = 0.0001) and sodium level (AOR = 3.435, 95%CI = 1.439–8.198, p-value = 0.005).ConclusionsAssessing and monitoring the laboratory markers of WBC, NLR, SGOT, sodium and potassium levels at the earliest stage of the disease could have a considerable role in halting disease progression and death.
Highlights
The growing threat due to the COVID-19 pandemic has caused numerous losses to the entire world
Assessing and monitoring the laboratory markers of white blood cell count (WBC), Neutrophil to Lymphocyte ratio (NLR), Serum glutamic oxaloacetic transaminase (SGOT), sodium and potassium levels at the earliest stage of the disease could have a considerable role in halting disease progression and death
An institution based retrospective cohort study was conducted at Millennium COVID-19 Care Center (MCCC), a makeshift hospital in Addis Ababa, Ethiopia
Summary
The growing threat due to the COVID-19 pandemic has caused numerous losses to the entire world. In the absence of a directed therapy and expanding vaccine service for the disease, identification of critical laboratory biomarkers for disease severity at early stage could help monitor and prevent disease progression towards severe form. To that aim studies to identify important clinical and laboratory biomarkers that can predict disease severity and outcome have been conducted. Laboratory and radiologic markers that can predict disease severity have been identified with varying results in the face of changing behavior of the disease and geographical disparity. Understanding predictors of disease severity and outcome are crucial to provide early preventive measures for a better outcome especially in economically developing country setup where intensive care setup might not match the increasing demand in the service
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