The Evaluation of Haematological and Biochemistry Parameters in COVID-19 Patients as a Predictive Factor for Unfavourable Evolution

Context Coronavirus disease 2019 (COVID-19) is a highly infectious disease. Severity of this disease is associated with comorbidities present (hypertension, obesity, pulmonary disease) or with age. Objective In this study, we evaluate haematological and biochemistry parameters in order to obtain indications for unfavourable evolution of the patient. Design and Setting We performed a prospective study that included all patients admitted in our hospital in Hematology, Pneumology, and ICU at Department Colentina Clinical Hospital during April and May 2020. Patients or other participants The study group included 80 patients that was split into ICU and non-ICU patients. All patients were SARS-CoV-2-positive by molecular test. The distribution according to gender was: 47 male with median age: 73 (min 35, max 88) and 33 female with median age: 50 (min 17, max 84). Results Age is an important risk factor for the severity, as the median age of patients admitted in ICU was 73 (min 43, max 88) compared with non-ICU patients 41 (min 17, max 64), p=0.00004. Comorbidities associated were important but were present in both groups. In ICU patients, we obtained lower level of lymphocytes compared with non ICU group median: 0.87× 103/L (min 0.09 × 103/L max 7.04 × 103/L) vs 2.17 × 103/L (min 0.19 × 103/L max 3.28 × 103/L), p=0.01. There are no significant differences between groups for the rest of haematological parameters. The biochemistry markers ferritin, AST, ALT, LDH, and D Dimers are important in evaluation of COVID-19 patients; there are statistical differences between ICU and non ICU patients (median value: LDH 405.5 UI/l vs 215 U/l, p=0.001; ferritin 1275 ng/ml vs. 161 ng/ml, p=0.002; D Dimers 2.61 mg/ml FEU vs 0.39 mg/ml FEU, p=0.002; AST 70.9 U/l vs. 19.9 U/l, p=0.0003; ALT 50.05 U/l vs. 18.5 U/l, p=0.009). The ICU patients with unfavourable evolution had a higher level of D-Dimers at the admission in hospital compared with ICU patients who was discharged from the hospital (3.42 mg/ml FEU vs 1.09 mg/ml FEU, p=0.01). We did not obtain statistical significance between ICU groups for all haematological and biochemistry parameters. Conclusions We conclude that lymphocyte count, LDH, AST, ALT, and ferritin at the time of hospital admission is important to evaluate in COVID-19 patient in order to expect a severe evolution of the disease. D-Dimer should be an important parameter to evaluate for all COVID-19 patients. Anti-thrombotic therapy is important to be introduced in COVID-19 patients.