ASSESSMENT OF THE PROGNOSTIC SIGNIFICANCE OF LABORATORY PARAMETERS AS FACTORS OF LETHAL OUTCOME IN PATIENTS WITH A NEW CORONAVIRUS INFECTION
https://doi.org/10.17802/2306-1278-2025-14-2-168-177
Abstract
Highlights
The analysis of laboratory parameters capable of assessing the lethal outcome in patients with COVID-19 was carried out. After that, these parameters were ranked depending on the magnitude of the odds ratio.
Abstract
Aim. To assess the predictive value of laboratory parameters as factors of lethal outcome in patients with novel coronavirus infection (COVID-19).
Methods. The prospective study included 164 patients hospitalized in a monoinfection hospital in the period from November 3, 2020 to January 15, 2021. The diagnosis of COVID-19 was verified by PCR testing for the presence of SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal specimens. Diagnosis, classification of pneumonia based on CT findings, disease severity according to the National Early Warning Score (NEWS), and treatment were conducted according to the “Temporary Guidelines. Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)”, version 9 (10/26/2020). The end of the study was the outcome of hospitalization: discharge or death. The main group consisted of 25 patients with a fatal outcome (Group 1), the 2nd group (n = 139) consisted of surviving patients.
Results. The mortality rate was 15.2%. 56% of the deceased were males, and 44% were females. The average age of the deceased was 72 years [68; 83], compared to 65 years [59,0; 70,5], р < 0,001 in the surviving group. 97.6% of patients were in clear consciousness, while 2.4% were in a state of stupor and soporific. Odds ratio (OR) analysis showed that predictors of fatal outcome in COVID-19 were elevated troponin concentration in blood (OR = 18,38 (95% confidence interval (CI) 6,503–51,97; p < 0,001), D-dimer level > 700 ng/mL (OR = 17,79; 95% CI 6,362–49,77; p < 0,001), procalcitonin (PCT) > 0.28 ng/mL (OR = 7,357; 95% CI 2,840–19,06; p < 0,001), and platelets < 180 × 109/L (OR = 4,76; 95% CI 2,00–11,1; p = 0,001). Monocytes ≥ 6.0% (OR = 0,205; 95% CI 0,067–0,627) were identified as a protective factor.
Conclusion. The most significant parameters for predicting prognosis in COVID-19 are troponin, D-dimer, PCT, and platelets. Monitoring these parameters will allow clinicians to identify patients at high risk of death early, requiring more active treatment measures.
About the Authors
Alla V. Svarovskaya
Cardiology Research Institute, branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”
Russian Federation
Russian Federation
PhD, Senior Researcher, Department of Myocardial Pathology, Cardiology Research Institute, branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”, Tomsk, Russian Federation
Pavel A. Astanin
Federal State Autonomous Educational Institution of Higher Education «N.I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation;
Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”
Russian Federation
Russian Federation
Post-graduate student of the Department of Medical Cybernetics and Computer Science, Employee (data Analyst) of the Institute of Digital Transformation of Medicine of the Federal State Autonomous Educational Institution of Higher Education «N.I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation, Moscow, Russian Federation; Junior Researcher at the Laboratory of Complex Problems of Risk Assessment for Public and Working Health of the Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”, Moscow, Russian Federation
Artem D. Vende
Federal State Funded Educational Institution of Higher Education “Siberian State Medical University” of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
6th year student at the Faculty of Medicine of the Federal State Funded Educational Institution of Higher Education “Siberian State Medical University” of the Ministry of Health of the Russian Federation, Tomsk, Russian Federation
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Supplementary files
Review
For citations:
Svarovskaya A.V., Astanin P.A., Vende A.D. ASSESSMENT OF THE PROGNOSTIC SIGNIFICANCE OF LABORATORY PARAMETERS AS FACTORS OF LETHAL OUTCOME IN PATIENTS WITH A NEW CORONAVIRUS INFECTION. Complex Issues of Cardiovascular Diseases. 2025;14(2):168-177. (In Russ.) https://doi.org/10.17802/2306-1278-2025-14-2-168-177
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