Criteria and potential predictors of severity in patients with COVID-19

Background The challenge in treating severe COVID-19 in the absence of targeted medication is enforcing physicians to search carefully for clinical predictors of severity. Aim To define the profile of patients at risk of severe COVID-19 and to assess for certain predictors. Methods Confirmed COVID-19 cases were classified into the following: group A: mild/moderate cases and group B: severe/critical cases according to the selected criteria. History, radiological assessment, complete blood count, lactate dehydrogenase (LDH), myocardial enzymes, serum ferritin, and D dimer were assessed. Patients were followed for the need of ICU and mechanical ventilation. Duration till conversion, length of stay, and mortality were recorded. Results A total of 202 patients were analyzed. Group B had higher age (53.2 +/- 12.6 vs 40.3 +/- 10.3, P < 0.001), more prevalence of DM (60.61% vs 16.57% P < 0.001), hypertension (51.52% vs 20.12%, P < 0.001), ischemic heart (27.27% vs 3.55%, P < 0.001), bronchial asthma (36.36% vs 3.55%, P < 0.001), COPD (9.09% vs 1.18%, P = 0.03), higher mean platelet volume (MPV) (12.76 +/- 7.13 vs 10.51 +/- 7.78 (fL), P < 0.001), higher serum ferritin (954 +/- 138 vs 447 +/- 166 ng/ml, P < 0.001), higher LDH (604 +/- 220 vs 384 +/- 183 U/L, P-value < 0.001), higher creatine phosphokinase (24.27 +/- 5.82 vs 16.4 +/- 4.87 IU/L, P < 0.001), and higher mortality (30.3% vs 0.6%, P < 0.001). Multivariate regression of predictors of severity identified three predictors; age, MPV, serum ferritin, and IHD. Conclusions The current study places of interest the characteristic host-related features of severe COVID-19 and draws attention to potential predictors.