Clinical Characteristics, Risk Factors and Short-Term Outcomes of Severe Cases of COVID-19: A Retrospective Analytic Single Center Study

Background & objectives: About 26% of hospitalised patients with COVID-19 have high mortality rates and up to 17% will require ventilatory support and critical care. We aimed to evaluate the clinical characteristics of patients with severe COVID-19, short- term outcomes (discharge, ventilator free, mechanical ventilation, dead) & their predictive values.
Methods: This retrospective analytic single center study included 80 hospitalized patients with severe COVID-19. Clinical data, complications and outcomes including admission to an ICU, use of non-invasive ventilation, and death, were analysed. The in-hospital complications were ARDS, pneumonia, hyperglycemia, shock, acute kidney injury. Levels of D-dimer, ferritin and lactate were measured. ROC analysis was used & p- value≤ 0.05 was considered statistically significant.
Results: The mean age was 53.45± 13.17years (range 18-77 years) and 46 (51%) were males. ARDS was the most common complication followed by hyperglycemia. Out of 80 patients; 52(65%) patients used CPAP and 25(31.25%) used non-invasive ventilator; 59 patients died with mortality rate (73.75%). There was a statistically significant association between lymphocyte count, neutrophil count and neutrophil- lymphocyte ratio (NLR), D- dimer, S. Ferritin and lactate with the development of ARDS. As predictors for mortality; the AUC for lactate, ferritin& D-dimer was [(0.902, 95%CI= 0.830-0.973, p < 0.001), (0.800, 95%CI= 0.678-0.923, p < 0.001), (0.757, 95%CI= 0.637-0.877, p=0.001)] respectively.
Conclusions: High levels of (S. Ferritin, D-dimer and NLR) are correlated with increased mortality in cases of severe Covid-19, and that the development of ARDS was associated with neutrophil& lymphocyte count, S. Ferritin, D-dimer and NLR.