Highlights • Decrease in %LUC (Large unstained cells%) value predicts severe SARS-CoV-2 infection. • Laboratory parameters associated with the severe illness in COVID-19 patients. • The optimal cut-off values of relevant parameters to define risk of critical illness. • The relevant coagulation abnormalities to predict severe patients with COVID-19. Background Coronavirus disease 2019 (COVID-19) emerged first in December 2019 in Wuhan, China and quickly spread throughout the world. Clinical and laboratory data are of importance to increase the success in the management of COVID-19 patients. Methods Data were obtained retrospectively from medical records of 191 hospitalized patients diagnosed with COVID-19 from a tertiary single-center hospital between March and April 2020. Prognostic effects of variables on admission among patients who received intensive care unit (ICU) support and those who didn’t require ICU care were compared. Results Patients required ICU care (n = 46) were older (median, 71 vs. 43 years), with more underlying comorbidities (76.1% vs. 33.1%). ICU patients had lower lymphocytes, percentage of large unstained cell (%LUC), hemoglobin, total protein, and albumin, but higher leucocytes, neutrophils, neutrophil–lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocytes ratio (PLR), urea, creatinine, aspartate amino transferase (AST), lactate dehydrogenase (LDH), and D-dimer when compared with non-critically ill patients (p < 0.001). A logistic regression model was created to include ferritin, %LUC, NLR, and D-dimer. %LUC decrease and D-dimer increase had the highest odds ratios (0.093 vs 5.597, respectively) to predict severe prognosis. D-dimer, CRP, and NLR had the highest AUC in the ROC analysis (0.896, 0.874, 0.861, respectively). Conclusions The comprehensive analysis of clinical and admission laboratory parameters to identify patients with severe prognosis is important not only for the follow-up of the patients but also to identify the pathophysiology of the disease. %LUC decrease and D-dimer, NLR, and CRP increases seem to be the most powerful laboratory predictors of severe prognosis.
【초록키워드】 COVID-19, Neutrophils, Coronavirus disease 2019, Lymphocytes, intensive care, Prognosis, hospital, Infection, LDH, Comorbidity, risk, CRP, D-dimer, ferritin, lactate dehydrogenase, ICU, Laboratory, Coagulation, Spread, Protein, pathophysiology, clinical, management, Patient, albumin, AST, Follow-up, hemoglobin, Severe patient, predictor, Admission, Critical, predict, COVID-19 patients, ROC analysis, NLR, creatinine, Odds ratio, AUC, urea, medical record, Support, Older, ICU care, comprehensive analysis, laboratory data, logistic regression model, leucocytes, single-center, cut-off value, abnormality, parameter, variable, neutrophil–lymphocyte ratio, Effect, MLR, laboratory parameter, Cell, ICU patient, decrease, severe SARS-CoV-2, Wuhan, China, Result, highest, identify, include, the patient, the disease, required, median, increase, hospitalized patient, to define, aspartate amino transferase, diagnosed with COVID-19, non-critically ill patient, with COVID-19, 【제목키워드】 Prognosis, clinical, laboratory feature,