tetano
Editor, Senior Moderator
PLoS One
. 2022 Nov 4;17(11):e0275832.
doi: 10.1371/journal.pone.0275832. eCollection 2022.
Haematological predictors of poor outcome among COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa
Zivanai C Chapanduka[SUP] 1 [/SUP], Ibtisam Abdullah[SUP] 1 [/SUP], Brian Allwood[SUP] 2 [/SUP], Coenraad F Koegelenberg[SUP] 2 [/SUP], Elvis Irusen[SUP] 2 [/SUP], Usha Lalla[SUP] 2 [/SUP], Annalise E Zemlin[SUP] 3 [/SUP], Tandi E Masha[SUP] 4 [/SUP], Rajiv T Erasmus[SUP] 3 [/SUP], Thumeka P Jalavu[SUP] 3 [/SUP], Veranyuy D Ngah[SUP] 5 [/SUP], Anteneh Yalew[SUP] 5 6 7 [/SUP], Lovemore N Sigwadhi[SUP] 5 [/SUP], Nicola Baines[SUP] 2 [/SUP], Jacques L Tamuzi[SUP] 5 [/SUP], Marli McAllister[SUP] 5 [/SUP], Anne K Barasa[SUP] 8 [/SUP], Valerie K Magutu[SUP] 8 [/SUP], Caroline Njeru[SUP] 8 [/SUP], Angela Amayo[SUP] 8 [/SUP], Marianne W Wanjiru Mureithi[SUP] 8 [/SUP], Mary Mungania[SUP] 9 [/SUP], Musa Sono-Setati[SUP] 10 [/SUP], Alimuddin Zumla[SUP] 11 [/SUP], Peter S Nyasulu[SUP] 5 12 [/SUP]
Affiliations
Abstract
Background: Studies from Asia, Europe and the USA indicate that widely available haematological parameters could be used to determine the clinical severity of Coronavirus disease 2019 (COVID-19) and predict management outcome. There is limited data from Africa on their usefulness in patients admitted to Intensive Care Units (ICUs). We performed an evaluation of baseline haematological parameters as prognostic biomarkers in ICU COVID-19 patients.
Methods: Demographic, clinical and laboratory data were collected prospectively on patients with confirmed COVID-19, admitted to the adult ICU in a tertiary hospital in Cape Town, South Africa, between March 2020 and February 2021. Robust Poisson regression methods and receiver operating characteristic (ROC) curves were used to explore the association of haematological parameters with COVID-19 severity and mortality.
Results: A total of 490 patients (median age 54.1 years) were included, of whom 237 (48%) were female. The median duration of ICU stay was 6 days and 309/490 (63%) patients died. Raised neutrophil count and neutrophil/lymphocyte ratio (NLR) were associated with worse outcome. Independent risk factors associated with mortality were age (ARR 1.01, 95%CI 1.0-1.02; p = 0.002); female sex (ARR 1.23, 95%CI 1.05-1.42; p = 0.008) and D-dimer levels (ARR 1.01, 95%CI 1.002-1.03; p = 0.016).
Conclusions: Our study showed that raised neutrophil count, NLR and D-dimer at the time of ICU admission were associated with higher mortality. Contrary to what has previously been reported, our study revealed females admitted to the ICU had a higher risk of mortality.
. 2022 Nov 4;17(11):e0275832.
doi: 10.1371/journal.pone.0275832. eCollection 2022.
Haematological predictors of poor outcome among COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa
Zivanai C Chapanduka[SUP] 1 [/SUP], Ibtisam Abdullah[SUP] 1 [/SUP], Brian Allwood[SUP] 2 [/SUP], Coenraad F Koegelenberg[SUP] 2 [/SUP], Elvis Irusen[SUP] 2 [/SUP], Usha Lalla[SUP] 2 [/SUP], Annalise E Zemlin[SUP] 3 [/SUP], Tandi E Masha[SUP] 4 [/SUP], Rajiv T Erasmus[SUP] 3 [/SUP], Thumeka P Jalavu[SUP] 3 [/SUP], Veranyuy D Ngah[SUP] 5 [/SUP], Anteneh Yalew[SUP] 5 6 7 [/SUP], Lovemore N Sigwadhi[SUP] 5 [/SUP], Nicola Baines[SUP] 2 [/SUP], Jacques L Tamuzi[SUP] 5 [/SUP], Marli McAllister[SUP] 5 [/SUP], Anne K Barasa[SUP] 8 [/SUP], Valerie K Magutu[SUP] 8 [/SUP], Caroline Njeru[SUP] 8 [/SUP], Angela Amayo[SUP] 8 [/SUP], Marianne W Wanjiru Mureithi[SUP] 8 [/SUP], Mary Mungania[SUP] 9 [/SUP], Musa Sono-Setati[SUP] 10 [/SUP], Alimuddin Zumla[SUP] 11 [/SUP], Peter S Nyasulu[SUP] 5 12 [/SUP]
Affiliations
- PMID: 36331976
- DOI: 10.1371/journal.pone.0275832
Abstract
Background: Studies from Asia, Europe and the USA indicate that widely available haematological parameters could be used to determine the clinical severity of Coronavirus disease 2019 (COVID-19) and predict management outcome. There is limited data from Africa on their usefulness in patients admitted to Intensive Care Units (ICUs). We performed an evaluation of baseline haematological parameters as prognostic biomarkers in ICU COVID-19 patients.
Methods: Demographic, clinical and laboratory data were collected prospectively on patients with confirmed COVID-19, admitted to the adult ICU in a tertiary hospital in Cape Town, South Africa, between March 2020 and February 2021. Robust Poisson regression methods and receiver operating characteristic (ROC) curves were used to explore the association of haematological parameters with COVID-19 severity and mortality.
Results: A total of 490 patients (median age 54.1 years) were included, of whom 237 (48%) were female. The median duration of ICU stay was 6 days and 309/490 (63%) patients died. Raised neutrophil count and neutrophil/lymphocyte ratio (NLR) were associated with worse outcome. Independent risk factors associated with mortality were age (ARR 1.01, 95%CI 1.0-1.02; p = 0.002); female sex (ARR 1.23, 95%CI 1.05-1.42; p = 0.008) and D-dimer levels (ARR 1.01, 95%CI 1.002-1.03; p = 0.016).
Conclusions: Our study showed that raised neutrophil count, NLR and D-dimer at the time of ICU admission were associated with higher mortality. Contrary to what has previously been reported, our study revealed females admitted to the ICU had a higher risk of mortality.