简介COVID-19大流行在印度取得了进展,从少数病例开始,蔓延到全国;最终成为全球受影响第二大的国家。这里,我们介绍了COVID-19的临床和实验室概况以及与死亡相关的危险因素.这项研究来自喀拉拉邦,该地区报告了印度的第一例病例。喀拉拉邦是该国第二高的病例负担,但也设法使病死率低于全国平均水平。方法这是一项单中心回顾性横断面研究,对2020年9月至2020年10月期间391例经实验室确认的COVID-19阳性住院患者进行研究。血液学参数,凝血参数,肝功能测试(LFT),收集和肾功能测试(RFT)结果,并在幸存者和非幸存者之间进行比较,以确定死亡率的预测生物标志物.结果所有患者的平均年龄为53.2岁(SD17.0)。在双变量分析中,总白细胞计数(TLC)的平均值,中性粒细胞绝对计数(ANC),中性粒细胞与淋巴细胞比率(NLR),C反应蛋白(CRP),铁蛋白,乳酸脱氢酶(LDH),入院时D-二聚体,凝血酶原时间国际标准化比率(PTINR),血尿素氮(BUN),非幸存者的肌酐和肌酐显着高于幸存者:平均值(SD)11.9(7.6)vs7.5(4.2)(x109/L),10.5(7.4)vs5.3(4.1)(x109/L),11.6(13.5)对3.4(3.5),185(117)对48(85)(mg/L),829.4(551.2)对323.6(374.1)(ng/ml),905.5(589.1)对485.1(353.9)(U/L),4.01(3.53)对1.29(2.08)(µg/ml),1.21(0.42)对0.99(0.18),105.1(91.4)对33.6(31.0)(mg/dl),3.6(4.1)对1.1(1.6)(mg/dl),分别,p<0.001。淋巴细胞绝对计数,血清白蛋白,和白蛋白/球蛋白(A/G)比低于幸存者(平均(SD)1.3(1.0)比2.0(0.9)(x109/L),p<0.001;3.0(0.7)对3.8(2.1)(g/dl),p0.005;0.9(0.3)对1.2(0.4),p<0.001)。多变量分析确定了ANC,入院时D-二聚体,CRP,BUN是与死亡率相关的独立预后因素。结论几个可访问的测试,如TLC,ANC,NLR,和BUN可用于低资源环境,以评估COVID-19患者的严重程度。此外,ANC,入院时D-二聚体,CRP,和BUN可作为COVID-19患者住院死亡率的独立预测因子。
Introduction The COVID-19 pandemic gained ground in India, starting from a few cases and spreading to the whole country; eventually becoming the second-most affected country worldwide. Here, we present the clinical and laboratory profile and the risk factors associated with mortality in COVID-19. The
study comes from Kerala, a region that reported the first case in India. Kerala has the second-highest case burden in the country but also has managed to keep the case fatality rate down below the national average. Methodology This is a single-center retrospective cross-sectional
study on 391 laboratory-confirmed COVID-19 positive inpatients between September 2020 and October 2020. Hematological parameters, coagulation parameters, liver function tests (LFT), and renal function tests (RFT) results were collected and compared among survivors and non-survivors to identify predictive biomarkers of mortality. Results The mean age of all patients was 53.2 years (SD 17.0). On bivariate analyses, the mean values of total leukocyte count (TLC), absolute neutrophil count (ANC), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), D-dimer at admission, prothrombin time international normalized ratio (PT INR), blood urea nitrogen (BUN), and creatinine were significantly higher in non-survivors than in survivors: mean (SD) 11.9 (7.6) vs 7.5 (4.2) (x109/L), 10.5 (7.4) vs 5.3 (4.1) (x109/L), 11.6 (13.5) vs 3.4 (3.5), 185 (117) vs 48 (85) (mg/L), 829.4 (551.2) vs 323.6 (374.1) (ng/ml), 905.5 (589.1) vs 485.1 (353.9) (U/L), 4.01 (3.53) vs 1.29 (2.08) (µg/ml), 1.21 (0.42) vs 0.99 (0.18), 105.1 (91.4) vs 33.6 (31.0) (mg/dl), 3.6 (4.1) vs 1.1 (1.6) (mg/dl), respectively, p < 0.001. Absolute lymphocyte count, serum albumin, and albumin/globulin (A/G) ratio were lower in non-survivors than in survivors (mean (SD) 1.3 (1.0) vs 2.0 (0.9) (x109/L), p < 0.001; 3.0 (0.7) vs 3.8 (2.1) (g/dl), p 0.005; 0.9 (0.3) vs 1.2 (0.4), p < 0.001). Multivariate analysis identified ANC, D-dimer at admission, CRP, and BUN as independent prognostic factors associated with mortality. Conclusion Several accessible tests like TLC, ANC, NLR, and BUN can be used in low-resource settings to assess severity in patients with COVID-19. In addition, ANC, D-dimer at admission, CRP, and BUN can be used as independent predictors of in-patient mortality in COVID-19 patients in hospital settings.