Abstract
The objective of this retrospective case control study was to determine clinical and biochemical parameters associated with a poorer prognostic outcome in both COVID-19 and non-COVID-19 pneumonias and use these to create safe discharge guidelines. This study in a single respiratory ward of a district general hospital compared admission and discharge C- reactive protein (CRP) levels, eosinophil and lymphocyte counts, respiratory rate, oxygen saturations and NEWS2 score from two groups of patients admitted with either confirmed COVID-19 pneumonia (46 patients) or pneumonia of other aetiology (45 patients). Outcome was defined as either ‘good’ or ‘poor’. Combined values of prognostic markers analysed by binary logistic regression followed by ROC analysis showed a final combined AUC value of 0.955 thus yielding a test that had a better prognostic capability in predicting the outcome of patients with COVID-19. This combined test could be used to guide safe discharge of patients with COVID-19.
Highlights
The SARS-CoV-2 is a novel, single stranded RNA virus currently at the centre of a pandemic that has led to significant mortality around the world
- The Kruskal-Wallis test carried out to determine the differences between various prognostic factors in patients with COVID-19 compared to patients with non COVID-19 Pneumonia
Six clinical and biochemical features were highlighted in the Receiver Operating Curve (ROC) curve analysis as being helpful in predicting safe and successful discharge from hospital; eosinophil count, Creactive protein (CRP) levels, lymphocyte count, respiratory rate, oxygen saturation levels and NEWS2 scores (Fig-2)
Summary
The SARS-CoV-2 is a novel, single stranded RNA virus currently at the centre of a pandemic that has led to significant mortality around the world. Various blood markers are altered significantly in those with COVID-19 and have been shown to play a role in aiding diagnosis as well as identifying a more severe course of disease. Many of these have been examined to aid in identifying patients both likely to have the disease, and those likely to run a more severe disease course [1]. Original Article has been suggested to be an indicator of the diagnosis of COVID-19 [2], supported by other studies that have concluded that the presence of eosinopenia was observed more frequently in those testing positive for SARS-CoV-2 as compared to those testing negative [3,4]. The presence or absence of eosinopenia has previously been suggested to be associated with worse outcomes though there has recently been debate over this [5]
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