Abstract
Introduction There are currently no satisfactory methods for predicting the outcome of Coronavirus Disease-2019 (COVID-19). The aim of this study is to establish a model for predicting the prognosis of the disease.
Methods The laboratory results were collected from 54 deceased COVID-19 patients on admission and before death. Another 54 recovered COVID-19 patients were enrolled as control cases.
Results Many laboratory indicators, such as neutrophils, AST, γ-GT, ALP, LDH, NT-proBNP, Hs-cTnT, PT, APTT, D-dimer, IL-2R, IL-6, IL-8, IL-10, TNF-α, CRP, ferritin and procalcitonin, were all significantly increased in deceased patients compared with recovered patients on admission. In contrast, other indicators such as lymphocytes, platelets, total protein and albumin were significantly decreased in deceased patients on admission. Some indicators such as neutrophils and procalcitonin, others such as lymphocytes and platelets, continuously increased or decreased from admission to death in deceased patients respectively. Using these indicators alone had moderate performance in differentiating between recovered and deceased COVID-19 patients. A model based on combination of four indicators (P = 1/[1 + e−(−2.658+0.587×neutrophils – 2.087×lymphocytes – 0.01×platelets+0.004×IL−2R)]) showed good performance in predicting the death of COVID-19 patients. When cutoff value of 0.572 was used, the sensitivity and specificity of the prediction model were 90.74% and 94.44%, respectively.
Conclusions Using the current indicators alone is of modest value in differentiating between recovered and deceased COVID-19 patients. A prediction model based on combination of neutrophils, lymphocytes, platelets and IL-2R shows good performance in predicting the outcome of COVID-19.
1. Introduction
A novel severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which can cause severe respiratory infection in humans [1,2], has induced a serious outbreak worldwide [3–5]. The disease has been named as Coronavirus Disease-2019 (COVID-19) by the World Health Organization (WHO). According to the report of National Health Commission of the People’s Republic of China, more than 80,000 patients are confirmed by SARS-CoV-2 infection, resulting in more than 3000 deaths. COVID-19 has been designated as a public health emergency of international concern by the WH
4. Discussion
There are rare studies that assess the risk for mortality of patients with COVID-19 [12,13]. There are a few studies focused on comparison of routine laboratory tests simultaneously between deceased and recovered COVID-19 patients. In the present study, we collected clinical information and laboratory results at different time points in patients died of confirmed SARS-CoV-2 infection. We also compared these data with those obtained in recovered COVID-19 patients. Our study confirmed that many indicators had significant difference between deceased and recovered patients on admission and that some indicators continuously increased from admission to death in deceased patients. A further established prediction model based on combination of four indicators (neutrophils, lymphocytes, platelets and IL-2R) showed satisfactory performance in predicting the death of COVID-19 patients
