Clinical and laboratory parameters in COVID-19 patients treated at the NMMCC ‘MMCH’

  • V. I. Trykhlib Ukrainian Military Medical Academy https://orcid.org/0000-0001-9250-4385
  • T. I. Lysenko Ukrainian Military Medical Academy
  • A. O. Yeroshenko Ukrainian Military Medical Academy
  • O. S. Martynchyk Ukrainian Military Medical Academy
Keywords: COVID-19, seriously ill, laboratory parameters.

Abstract

Introduction. The article presents a review of the literature and the results of our own examination of patients with new coronavirus infection COVID-19 with a severe course.

The purpose. To establish the features of laboratory indicators of the new coronavirus disease COVID-19 in seriously ill patients, who were treated in the ICU of the NMMCC ‘MMCH’ during the season of influenza activity due to previously found that community-acquired pneumonia in this period of the year has a more severe course.

Materials and methods The data of 112 medical records of an inpatient patients with a severe course of the new coronavirus disease COVID-19 were processed, who were treated in the ICU of the NMMCC ‘MMCH’ in the period from January to April 2021. The patients were distributed as follows: the first group - who recovered , the second – who died. All patients were diagnosed with pneumonia by chest x-ray or computed tomography. In all patients the diagnosis was confirmed by real-time PCR with the detection of SARS-COV-2 RNA. Statistical processing of research materials was carried out using a personal computer using the STATISTICA program. A questionnaire was developed for entering data into Excel.

Results. It was found that upon admission to the intensive care unit in patients who recovered and those who died, the mean leukocyte counts did not differ significantly (p>0.05). Those who died had large fluctuations in leukocyte levels during the first three days after admission. From the 4th day of stay, those who died had higher both average leukocyte counts and their quartile deviations (Q25 and Q75). On admission the number of lymphocytes was lower in those who died compared to those who recovered, but in the following days the former were further reduced or kept at a low level, while those who recovered had lowered numbers remaining at almost the same level and from day 9 of stay in hospital an increase was observed (p < 0.05 compared to those who died). The average level of granulocytes at admission was slightly higher in those who subsequently died, and subsequently their values increased, while those who recovered, on the contrary, values gradually decreased from the 4th day. In the first three days after hospitalization there was no difference in the level of stab neutrophils between those who died and those who recovered (p> 0,05), while those who recovered subsequently have a decrease in their number, and those who died, on the contrary, have an increase.  In the first three days there was no difference in the number of platelets between the groups, while those who died from day 9 had more pronounced fluctuations in their number. SLE indicators had more pronounced fluctuations in the first three days in those who recovered, and they subsequently showed a decrease in the level of SLE, while those who died after 7 days recorded a significant increase. AlAT, AsAT increased insignificantly. In the first three days after hospitalization, those who died had slightly higher urea levels compared to those who recovered (p>0.05). In both groups of patients, there was an increase in urea levels in the following days, but those who died had an increase to higher values. Also with regard to creatinine values, which were higher already at the beginning of hospitalization and after 7 days more pronounced fluctuations were registered in those who died than in those who recovered. In both groups of patients, elevated glucose levels were registered immediately after hospitalization (p>0.05). In those who recovered, there was a gradual decrease in glucose levels, and in those who died, on the contrary, there was an even greater increase after 4 days. Immediately after hospitalization, those who died had slightly higher CRP levels compared to those who recovered, but subsequently, from day 4, those who died registered a further increase, while those who recovered, on the contrary, decreased (p<0.05).

Conclusions. Patients who subsequently died were admitted earlier than those who recovered. During hospitalization, laboratory values may not differ between individuals who recover and those who die. At the beginning of hospitalization, more reduced levels of lymphocytes and high levels of granulocytes, urea, creatinine, CRP may indicate an unfavorable result. Already after 4 days of hospitalization (5-11 days of illness), the dynamics of the tests may indicate the further course of the disease and possible consequences (a decrease in the level of lymphocytes, the persistence of a high level or growth of granulocytes, the growth of stab neutrophils, the number of platelets, ESR, the level of urea, creatinine, CRP, procalcitonin - indicate an unfavorable outcome). Further research is needed on the nature and timing of kidney, heart, lung damage, microcirculation and their relationship.

Author Biographies

V. I. Trykhlib, Ukrainian Military Medical Academy

retired Colonel of the medical service, Doctor of Medical Sciences, Professor of the Department of Military Therapy of the Ukrainian Military Medical Academy

T. I. Lysenko, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

A. O. Yeroshenko, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

O. S. Martynchyk, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

References

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Published
2021-10-11
How to Cite
Trykhlib, V. I., Lysenko, T. I., Yeroshenko, A. O., & Martynchyk, O. S. (2021). Clinical and laboratory parameters in COVID-19 patients treated at the NMMCC ‘MMCH’. Ukrainian Journal of Military Medicine, 2(3), 54-66. https://doi.org/10.46847/ujmm.2021.3(2)-054
Section
Current aspects of diagnosis and treatment