The Role of Simple Blood Tests and a Modified Chest X-Ray Scoring System in Assessing the Severity Disease and Mortality Risk in COVID-19 Patients in a Secondary Hospital, Indonesia.

Autor: Soedarsono S; Sub-Pulmonology Department of Internal Medicine, Faculty of Medicine, Hang Tuah University, Surabaya, East Java, Indonesia., Yunita D; Medical and Health Service Management, Petrokimia Gresik Hospital, Gresik, East Java, Indonesia., Ayu Lirani E; Emergency Installation, Petrokimia Gresik Hospital, Gresik, East Java, Indonesia., Kartika Sari R; Emergency Installation, Petrokimia Gresik Hospital, Gresik, East Java, Indonesia., Indrawan Pratama Y; Emergency Installation, Petrokimia Gresik Hospital, Gresik, East Java, Indonesia., Listiati A; Emergency Installation, Petrokimia Gresik Hospital, Gresik, East Java, Indonesia., Supriyanto B; Department of Radiology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.
Jazyk: angličtina
Zdroj: International journal of general medicine [Int J Gen Med] 2022 Jun 30; Vol. 15, pp. 5891-5900. Date of Electronic Publication: 2022 Jun 30 (Print Publication: 2022).
DOI: 10.2147/IJGM.S367305
Abstrakt: Background: Coronavirus disease 2019 (COVID-19) has resulted in millions of mortality cases and significant incremental costs to the healthcare system. Examination of CRP and D-dimer were considered to have higher costs, and the use of simple hematological parameters such as lymphocyte, neutrophil, and white blood cell (WBC) which have more affordable costs would be cost-saving. Radiological imaging complements clinical evaluation and laboratory parameters for managing COVID-19 patients. Therefore, categorizing patients into severe or non-severe becomes more defined, allowing for earlier interventions and decisions of hospital admission or being referred to a tertiary hospital.
Purpose: To evaluate the variables correlated with poor outcomes in COVID-19 patients.
Patients and Methods: This was a retrospective study on COVID-19 patients in a secondary referral hospital in treating COVID-19 in Indonesia. Demographic, clinical data, laboratory parameters, CXR (analyzed using a modified scoring system), and prognosis were collected through electronic nursing and medical records.
Results: This study included 476 hospitalized COVID-19 patients. Severe patients were commonly found with older age (median of 57 vs 40), dyspnea (percentage of 85.2% vs 20.5%), higher CXR score (median of 7 vs 5), higher levels of neutrophil (median of 79.9 vs 68.3), and lower lymphocyte levels (median of 13.4 vs 22.7), compared to non-severe patients. These variables were known to increase the odds of severe disease. Older age (median of 57 vs 48), SpO 2 <94% room air (percentage of 87.4% vs 31.5%), higher CXR score (median of 8 vs 5), and higher respiratory rate (median of 25 vs 20) were found higher in death patients and were known to increase the odds of death outcome.
Conclusion: The simple blood tests (neutrophil and lymphocyte) and modified CXR scoring system are useful in risk stratification for severe disease and mortality in COVID-19 patients to decide the earlier interventions and treatment.
Competing Interests: The authors report no conflicts of interest in this work.
(© 2022 Soedarsono et al.)
Databáze: MEDLINE
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