BIOCHEMICAL AND HEMATOLOGICAL PARAMETERS AS PROGNOSTIC MARKERS IN COVID-19 PATIENTS
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Keywords
Prothrombin time. Activated partial thromboplastin time, Leukocytosis, hyponatremia
Abstract
This study aims to investigate the alteration in biochemical and heamatological parameters in Covid-19 patients. Total 200 patients were randomly selected during their hospitalization in Holy family Hospital Rawalpindi, Pakistan. The patients were then categorized as severe and non-severe group as per criteria provided by WHO and nasal swabs for qPCR analysis and blood sample were subjected to biochemical and heamatological profiles. The data was then subjected to statistical analysis using SPSS 24.0. Out of 200 patients, 49% (98) were females and 51% (102) were males. The mean age was of the study population was 52.45 years. The most frequent sign and symptoms were, cough, fever and shortness of breath. About 59.5 % (119) patients were categorized in severe group and 40.5% (81) were non-severe. The overall mortality was 21.0% (42) within hospital (mean stay at hospital 6.68 days). The most frequent comorbidities were HTN (37.5%), DM (33.5%) and IHD (13.5%). Among liver function test total bilirubin was found to be independent predictor for mortality (OR=2.517 C. I. 1.428-4.438) with p-value (0.001). The Odds ratio for urea and creatinine (OR=6.407 C. I 2.188-18.763) respectively. Among electrolytes chloride having the Odd ratio (2.536 C. I 1.189 5.405 with p-value 0.016) was found independent mortality predictor. In coagulation markers PT (OR= 3.722 C. I 1.018-13.610, p-value 0.047) and for APTT (OR=4.873 C. I 1.856-12.794 p-value 0.001) were independent predictor of mortality. Lastly, among heamatological parameters TLC (OR=4.004 C. I 1.816-8.827, p-value 0.001), neutrophil count (OR=4.148 C. I 1.320-13.033, p-value 0.015) and NLR (OR=2.081 C. I 1.388-3.120, p-value <0.001). This study demonstrates the association of various comorbidities, biochemical and heamatological parameters with Covid-19 severity and mortality. Hypertension, diabetes mellitus, ischemic heart diseases and advance age were significantly associated with severe Covid-19 infection. ALT, total bilirubin, urea, creatinine prothrombin time and APTT was significantly increased in severe patients. Hyponatremia was profound in deceased patients and hypochloremia was profound in severe Covid-19 cases. Leukocytosis, neutrophilia, thrombocytopenia and NLR were also associated with severe Covid-19 infection.
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Augustine Michael
M. Phil Scholar, University Institute of Biochemistry and Biotechnology, PMAS Arid Agriculture University, Rawalpindi, Pakistan.
Muhammad Javaid Asad
Professor, University Institute of Biochemistry and Biotechnology, PMAS Arid Agriculture University, Rawalpindi, Pakistan.
Dr. Naeem Akhtar
Professor of Pathology (Microbiology), Rawalpindi Medical University, Rawalpindi, Pakistan
Dr. Muhammad Mujeeb Khan
Assistant Professor of medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Dr. Uzma Abdullah
Assistant Professor, University Institute of Biochemistry and Biotechnology, PMAS Arid Agriculture University, Rawalpindi, Pakistan.
Muhammad Bilal
M. Phil Scholar, University Institute of Biochemistry and Biotechnology, PMAS Arid Agriculture University, Rawalpindi, Pakistan.
Iqra Akhlaq Malik
M. Phil Scholar, University Institute of Biochemistry and Biotechnology, PMAS Arid Agriculture University, Rawalpindi, Pakistan.
Ahmad Faraz
M. Phil Scholar, University Institute of Biochemistry and Biotechnology, PMAS Arid Agriculture University, Rawalpindi, Pakistan.