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Abstract：
BACKGROUND: COVID-19 illness severity ranges from mild- to life-threatening cases necessitating critical care. Rapid prediction of disease severity and the need for critical care support in COVID-19 patients remain essential, not only for current management but also for preparedness in future pandemics. This study aimed to assess hematological parameters as predictors of intensive care unit (ICU) admission and survival in COVID-19 patients, providing insights applicable to a broad range of infectious diseases.
METHODS: A case-control study was conducted at Hospital Raja Perempuan Zainab II, a tertiary referral hospital in Kelantan, Malaysia, from March 2020 to August 2021. Demographics, clinical, and laboratory data were retrieved from patients\' medical records. Statistical analyses, including the Chi-square (χ2) test, independent t-tests, and simple and multiple logistic regressions, were used to analyze the data. A receiver operating characteristic (ROC) curve analysis was conducted to assess the accuracy of the predictors.
RESULTS: The median age was 51 years, with females comprising 56.7% (n=148) and males 43.3% (n=113). A total of 88.5% of patients were admitted to non-ICU wards, with a mortality rate of 5.7%. Significant differences were observed in the distribution of hematological parameters between ICU-admitted and non-admitted patients. Neutrophil (OR: 23.96, 95% CI: 7.296-78.675) and white blood cell (WBC) count (OR: 36.677, 95% CI: 2.086-644.889) were the most significant predictors for ICU admission and survival, respectively.
CONCLUSIONS: WBC and neutrophil counts exhibited high predictive value for ICU admission, while WBC, neutrophil, lymphocyte, and immature granulocyte (IG) counts were significant predictors of survival status among COVID-19 patients. These findings underscore the continued relevance of hematological markers in managing severe respiratory infections and improving critical care triage, with implications for current and future healthcare challenges.
METHODS: A case-control study was conducted at Hospital Raja Perempuan Zainab II, a tertiary referral hospital in Kelantan, Malaysia, from March 2020 to August 2021. Demographics, clinical, and laboratory data were retrieved from patients\' medical records. Statistical analyses, including the Chi-square (χ2) test, independent t-tests, and simple and multiple logistic regressions, were used to analyze the data. A receiver operating characteristic (ROC) curve analysis was conducted to assess the accuracy of the predictors.
RESULTS: The median age was 51 years, with females comprising 56.7% (n=148) and males 43.3% (n=113). A total of 88.5% of patients were admitted to non-ICU wards, with a mortality rate of 5.7%. Significant differences were observed in the distribution of hematological parameters between ICU-admitted and non-admitted patients. Neutrophil (OR: 23.96, 95% CI: 7.296-78.675) and white blood cell (WBC) count (OR: 36.677, 95% CI: 2.086-644.889) were the most significant predictors for ICU admission and survival, respectively.
CONCLUSIONS: WBC and neutrophil counts exhibited high predictive value for ICU admission, while WBC, neutrophil, lymphocyte, and immature granulocyte (IG) counts were significant predictors of survival status among COVID-19 patients. These findings underscore the continued relevance of hematological markers in managing severe respiratory infections and improving critical care triage, with implications for current and future healthcare challenges.
摘要：
背景：COVID-19疾病的严重程度从轻度到危及生命的病例不等，需要重症监护。快速预测COVID-19患者的疾病严重程度和对重症监护支持的需求仍然至关重要，不仅是为了当前的管理，也是为了未来大流行的准备。本研究旨在评估血液学参数作为COVID-19患者重症监护病房（ICU）入院和生存的预测因子，提供适用于各种传染病的见解。
方法：在RajaPerempuanZainabII医院进行了一项病例对照研究，吉兰丹的一家三级转诊医院，马来西亚,从2020年3月到2021年8月。人口统计,临床,和实验室数据从患者的医疗记录中检索。统计分析，包括卡方(χ2)检验，独立t检验，以及简单和多重逻辑回归，用于分析数据。进行受试者工作特征（ROC）曲线分析以评估预测因子的准确性。
结果：中位年龄为51岁，女性占56.7%(n=148)，男性占43.3%(n=113)。共有88.5%的病人入住非重症监护病房,死亡率为5.7%。ICU入院和非入院患者之间的血液学参数分布存在显着差异。中性粒细胞（OR：23.96，95％CI：7.296-78.675）和白细胞（WBC）计数（OR：36.677，95％CI：2.086-644.889）是ICU入院和生存的最重要预测因子。分别。
结论：白细胞和中性粒细胞计数对ICU入院具有较高的预测价值，而WBC,中性粒细胞,淋巴细胞，未成熟粒细胞（IG）计数是COVID-19患者生存状态的重要预测因子。这些发现强调了血液学标志物在管理严重呼吸道感染和改善重症监护分诊方面的持续相关性。对当前和未来的医疗保健挑战产生影响。
方法：在RajaPerempuanZainabII医院进行了一项病例对照研究，吉兰丹的一家三级转诊医院，马来西亚,从2020年3月到2021年8月。人口统计,临床,和实验室数据从患者的医疗记录中检索。统计分析，包括卡方(χ2)检验，独立t检验，以及简单和多重逻辑回归，用于分析数据。进行受试者工作特征（ROC）曲线分析以评估预测因子的准确性。
结果：中位年龄为51岁，女性占56.7%(n=148)，男性占43.3%(n=113)。共有88.5%的病人入住非重症监护病房,死亡率为5.7%。ICU入院和非入院患者之间的血液学参数分布存在显着差异。中性粒细胞（OR：23.96，95％CI：7.296-78.675）和白细胞（WBC）计数（OR：36.677，95％CI：2.086-644.889）是ICU入院和生存的最重要预测因子。分别。
结论：白细胞和中性粒细胞计数对ICU入院具有较高的预测价值，而WBC,中性粒细胞,淋巴细胞，未成熟粒细胞（IG）计数是COVID-19患者生存状态的重要预测因子。这些发现强调了血液学标志物在管理严重呼吸道感染和改善重症监护分诊方面的持续相关性。对当前和未来的医疗保健挑战产生影响。
