Evaluation of laboratory exams and symptoms of patients with molecular diagnosis (RT-qPCR) of COVID-19 admitted to an Intensive Care Unit in a Western Parana city
Keywords:COVID-19; SARS-CoV-2; Prognosis; Laboratory markers; Symptomatology; Mortality.
The pandemic triggered by COVID-19 has been plaguing the world since December 2019, without any known specific treatment, leading to nearly 3 million deaths worldwide. Its transmission occurs from person to person and its main symptoms are fever, dry cough and fatigue. The aim of this study was to analyze the prognosis of patients with SARS-CoV-2 admitted to an Intensive Care Unit in the West region of Parana, through hematological and symptomatological parameters, helping in the establishment of protocols and procedures. From the data obtained, there was a greater number of deaths among older patients (p=0,01), and the laboratory profile with the worst prognosis was with hematocritopenia, leukocytosis, lymphocytopenia, neutrocytosis and greater number of respiratory symptoms. There was no association between sex and death (p=0,13) or length of stay (p=0,36). Therefore, new studies can use these laboratory and symptomatological markers, as well as age, to assist in the pandemic medical routine.
Chen, G., Wu, D., Guo, W., Cao, Y., Huang, D., Wang, H., Wang, T., Zhang, X., Chen, H., Yu, H., Zhang, X., Zhang, M., Wu, S., Song, J., Chen, T., Han, M., Li, S., Luo, X., Zhao, J., & Ning, Q. (2020). Clinical and immunological features of severe and moderate coronavirus disease 2019. Journal of Clinical Investigation, 130(5), 2620–2629. https://doi.org/10.1172/JCI137244
Driggin, E., Madhavan, M. V., Bikdeli, B., Chuich, T., Laracy, J., Biondi-Zoccai, G., Brown, T. S., Der Nigoghossian, C., Zidar, D. A., Haythe, J., Brodie, D., Beckman, J. A., Kirtane, A. J., Stone, G. W., Krumholz, H. M., & Parikh, S. A. (2020). Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. Journal of the American College of Cardiology, 75(18), 2352–2371. https://doi.org/10.1016/j.jacc.2020.03.031
Estrela, C. (2018). Metodologia Científica: ciência, ensino e pesquisa (3ª ed.). Porto Alegre: Artes Médicas.
Hamming, I., Timens, W., Bulthuis, M., Lely, A., Navis, G., & van Goor, H. (2004). Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. The Journal of Pathology, 203(2), 631–637. https://doi.org/10.1002/path.1570
Harenberg, J., & Favaloro, E. (2020). COVID-19: progression of disease and intravascular coagulation – present status and future perspectives. Clinical Chemistry and Laboratory Medicine (CCLM), 58(7), 1029–1036. https://doi.org/10.1515/cclm-2020-0502
Lai, C.-C., Shih, T.-P., Ko, W.-C., Tang, H.-J., & Hsueh, P.-R. (2020). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International Journal of Antimicrobial Agents, 55(3), 105924. https://doi.org/10.1016/j.ijantimicag.2020.105924
Li, Y., Bai, W., & Hashikawa, T. (2020). The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients. Journal of Medical Virology, 92(6), 552–555. https://doi.org/10.1002/jmv.25728
Liu W, & Li, H.. (2020). COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism. ChemRxiv, 105. https://doi.org/10.26434/chemrxiv.11938173
Madjid, M., Safavi-Naeini, P., Solomon, S. D., & Vardeny, O. (2020). Potential Effects of Coronaviruses on the Cardiovascular System. JAMA Cardiology, 5(7), 831. https://doi.org/10.1001/jamacardio.2020.1286
Maguire, D., Woods, M., Richards, C., Dolan, R., Veitch, J. W., Sim, W. M. J., Kemmett, O. E. H., Milton, D. C., Randall, S. L. W., Bui, L. D., Goldmann, N., Cameron, A., Laird, B., Talwar, D., Godber, I., Davidson, A., & McMillan, D. C. (2020). Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection. Journal of Translational Medicine, 18(1), 354. https://doi.org/10.1186/s12967-020-02524-4
Organização Pan-americana da Saúde (OPAS). (2020). Folha informativa – COVID-19 (doença causada pelo novo coronavírus). https://www.paho.org/bra/index.php?option=com_content&view=article&id=6101:covid19&Itemid=875
Pereira, M. D., Oliveira, L. C. de, Costa, C. F. T., Bezerra, C. M. de O., Pereira, M. D., Santos, C. K. A. dos, & Dantas, E. H. M. (2020). A pandemia de COVID-19, o isolamento social, consequências na saúde mental e estratégias de enfrentamento: uma revisão integrativa. Research, Society and Development, 9(7), e652974548. https://doi.org/10.33448/rsd-v9i7.4548
Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S., Tao, Y., Xie, C., Ma, K., Shang, K., Wang, W., & Tian, D.-S. (2020). Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infectious Diseases, 71(15), 762–768. https://doi.org/10.1093/cid/ciaa248
Tan, L., Wang, Q., Zhang, D., Ding, J., Huang, Q., Tang, Y.-Q., Wang, Q., & Miao, H. (2020). Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduction and Targeted Therapy, 5(1), 33. https://doi.org/10.1038/s41392-020-0148-4
Tang, N., Li, D., Wang, X., & Sun, Z. (2020). Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis, 18(4), 844–847. https://doi.org/10.1111/jth.14768
Terpos, E., Ntanasis‐Stathopoulos, I., Elalamy, I., Kastritis, E., Sergentanis, T. N., Politou, M., Psaltopoulou, T., Gerotziafas, G., & Dimopoulos, M. A. (2020). Hematological findings and complications of COVID‐19. American Journal of Hematology, 95(7), 834–847. https://doi.org/10.1002/ajh.25829
Wang, C., Deng, R., Gou, L., Fu, Z., Zhang, X., Shao, F., Wang, G., Fu, W., Xiao, J., Ding, X., Li, T., Xiao, X., & Li, C. (2020). Preliminary study to identify severe from moderate cases of COVID-19 using combined hematology parameters. Annals of Translational Medicine, 8(9), 593–593. https://doi.org/10.21037/atm-20-3391
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X., & Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA, 323(11), 1061. https://doi.org/10.1001/jama.2020.1585
Wang, J., Jiang, M., Chen, X., & Montaner, L. J. (2020). Cytokine storm and leukocyte changes in mild versus severe SARS‐CoV‐2 infection: Review of 3939 COVID‐19 patients in China and emerging pathogenesis and therapy concepts. Journal of Leukocyte Biology, 108(1), 17–41. https://doi.org/10.1002/JLB.3COVR0520-272R
Wu, Y., Huang, X., Sun, J., Xie, T., Lei, Y., Muhammad, J., Li, X., Zeng, X., Zhou, F., Qin, H., Shao, L., & Zhang, Q. (2020). Clinical Characteristics and Immune Injury Mechanisms in 71 Patients with COVID-19. MSphere, 5(4). https://doi.org/10.1128/mSphere.00362-20
Xie, J., Ding, C., Li, J., Wang, Y., Guo, H., Lu, Z., Wang, J., Zheng, C., Jin, T., Gao, Y., & He, H. (2020). Characteristics of patients with coronavirus disease (COVID‐19) confirmed using an IgM‐IgG antibody test. Journal of Medical Virology, 92(10), 2004–2010. https://doi.org/10.1002/jmv.25930
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R., Niu, P., Zhan, F., Ma, X., Wang, D., Xu, W., Wu, G., Gao, G. F., & Tan, W. (2020). A Novel Coronavirus from Patients with Pneumonia in China, 2019. New England Journal of Medicine, 382(8), 727–733. https://doi.org/10.1056/NEJMoa2001017
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Copyright (c) 2021 Anderson Dillmann Groto; Wesley Gabriel Novaes Botelho; Beatriz Paiola Albrecht; Jéssica Cristina Ruths; Maurício Bedim dos Santos; Kádima Nayara Teixeira; Alcântara Ramos de Assis César
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