Abstract
Objective An outbreak of coronavirus disease-19 (COVID-19) began in December 2019 and spread globally, overwhelming the entire world. COVID-19 is a public health emergency of international concern. Due to its high morbidity and mortality rate, recognition of its risk and prognostic factors is important. We aimed to understand the relationship between metabolic and endocrine parameters and the prognosis of COVID-19. Methods and Materials This was a cross-sectional clinical study. A total of 70 patients with severe COVID-19 were enrolled. Laboratory results at the first admission time (including complete blood count, C-reactive protein, lactate dehydrogenase, blood glucose, calcium, phosphate, albumin, creatinine, magnesium, lipid profiles, liver enzymes, thyroid hormones, cortisol, and vitamin D) and outcome data were recorded. We divided patients into (1) intensive care unit- (ICU-) admitted and non-ICU-admitted and (2) survivors and nonsurvivors for estimation of severity and prognosis. We determined the risk factors associated with critical illness and poor prognosis. Results Patients with higher white blood cell (WBC) count and phosphate levels had significantly higher ICU admission rates. According to univariate analysis, serum levels of T3, phosphate, and WBC as well as the duration of hospitalization were associated with mortality. Multivariate analysis revealed that only WBC and duration of hospitalization were independent predictors for mortality rate in COVID-19 patients. Conclusion Our findings suggest that longer duration of hospitalization and higher WBC count are associated with poor outcomes in patients with COVID-19.
Highlights
The coronavirus disease-19 (COVID-19) pandemic in 2020 was a global crisis associated with high morbidity and mortality, especially in people with underlying diseases
It has been proposed that various comorbidities such as hypertension, diabetes mellitus (DM), obesity, cardiovascular disease (CVD), chronic respiratory disease, malignancies, and glucocorticoid use are among the most common chronic underlying disorders that predispose to and exacerbate COVID-19 infection [1, 2]
43.9% had a positive history of diabetes, 35% had a history of hypertension, and 18.4% had a positive history in favor of cardiovascular problems
Summary
The coronavirus disease-19 (COVID-19) pandemic in 2020 was a global crisis associated with high morbidity and mortality, especially in people with underlying diseases. It has been proposed that various comorbidities such as hypertension, diabetes mellitus (DM), obesity, cardiovascular disease (CVD), chronic respiratory disease, malignancies, and glucocorticoid use are among the most common chronic underlying disorders that predispose to and exacerbate COVID-19 infection [1, 2]. It has been found that the presence of DM is a major risk factor for the severity and poor prognosis of the disease because it confers an impaired immunologic system [6,7,8]. Functional adrenal insufficiency is possible during any severe disease and in patients treated with glucocorticoids due to primary and secondary adrenal insufficiency [13]. Measuring the adrenal response seems to be helpful in determining the severity and prognosis of COVID-19 disease
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