Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy

Clin Chem Lab Med. 2020 Jun 25;58(7):1100-1105. doi: 10.1515/cclm-2020-0459.

Abstract

Background Comprehensive information has been published on laboratory tests which may predict worse outcome in Asian populations with coronavirus disease 2019 (COVID-19). The aim of this study is to describe laboratory findings in a group of Italian COVID-19 patients in the area of Valcamonica, and correlate abnormalities with disease severity. Methods The final study population consisted of 144 patients diagnosed with COVID-19 (70 who died during hospital stay and 74 who survived and could be discharged) between March 1 and 30, 2020, in Valcamonica Hospital. Demographical, clinical and laboratory data were collected upon hospital admission and were then correlated with outcome (i.e. in-hospital death vs. discharge). Results Compared to patients who could be finally discharged, those who died during hospital stay displayed significantly higher values of serum glucose, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), urea, creatinine, high-sensitivity cardiac troponin I (hscTnI), prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), D-dimer, C reactive protein (CRP), ferritin and leukocytes (especially neutrophils), whilst values of albumin, hemoglobin and lymphocytes were significantly decreased. In multiple regression analysis, LDH, CRP, neutrophils, lymphocytes, albumin, APTT and age remained significant predictors of in-hospital death. A regression model incorporating these variables explained 80% of overall variance of in-hospital death. Conclusions The most important laboratory abnormalities described here in a subset of European COVID-19 patients residing in Valcamonica are highly predictive of in-hospital death and may be useful for guiding risk assessment and clinical decision-making.

Keywords: COVID-19; coronavirus disease 2019; laboratory medicine; laboratory tests.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arginine / blood
  • Aspartate Aminotransferases / blood
  • Betacoronavirus
  • Blood Glucose / analysis
  • C-Reactive Protein / analysis
  • Carnosine / blood
  • Clinical Laboratory Techniques
  • Comorbidity
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / physiopathology
  • Creatine Kinase / blood
  • Creatinine / blood
  • Drug Combinations
  • Female
  • Ferritins / blood
  • Fibrin Fibrinogen Degradation Products
  • Hospital Mortality
  • Humans
  • Italy
  • L-Lactate Dehydrogenase / blood
  • Leukocytes
  • Lymphocytes
  • Male
  • Middle Aged
  • Neutrophils
  • Pandemics
  • Partial Thromboplastin Time
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / physiopathology
  • Prothrombin Time
  • Serum Albumin, Human / analysis
  • Troponin I / blood
  • Urea / blood

Substances

  • Blood Glucose
  • Drug Combinations
  • Fibrin Fibrinogen Degradation Products
  • Troponin I
  • fibrin fragment D
  • ureadin Rx Db
  • Carnosine
  • Urea
  • C-Reactive Protein
  • Ferritins
  • Arginine
  • Creatinine
  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Creatine Kinase
  • Serum Albumin, Human

Supplementary concepts

  • COVID-19
  • COVID-19 diagnostic testing
  • severe acute respiratory syndrome coronavirus 2