Parameters Affecting the Clinical Course in COVID-19

Abstract

Introduction: The entire population is susceptible to COVID-19, and the course of the disease is in a wide spectrum between asymptomatic clinical and critical illness. In this study, it was aimed to see whether the laboratory level CRP, ferritin, D-dimer, lymphocyte and vitamin D values and sociodemographic characteristics are related to the clinical course of the disease in COVID-19 disease, which emerged at the end of 2019 and caused a pandemic all over the world. Materials and Methods: The study was carried out with a total of 100 participants, 50 patients who applied to Kahramanmaraş Sütçü İmam University Health Practice and Research Hospital, adult COVID-19 outpatient clinic and 50 patients who applied to the family medicine outpatient clinic between 25.01.2021 and 28.02.2021. The first part of the questionnaire was applied by face-to-face interview method during the application to the hospital and the second part was applied one month later to the participants who applied to the adult COVID-19 outpatient clinic with a positive RT-PCR test. In addition to the CRP, lymphocyte, ferritin and D-dimer values measured in the blood taken at the first visit, the serum vitamin D level was studied. Statistical evaluation of the obtained data was made using SPSS 22 program. For statistical significance, p value below 0.05 was considered significant. Results: A total of 100 people were included in this study. Fifty people with COVID-19 infection constitute the case group, and 50 people who have not had COVID-19 infection before constitute the control group. While the mean age was 51.14 ± 19.36 years in the case group, it was 37.12 ± 12.64 in the control group. The mean age of the patients in the case group was higher than the mean age of the patients in the control group (p< 0.05). Serum vitamin D result was 14.19 ± 10.63 ng/mL in the case group and 17.48 ± 12.69 ng/mL in the control group. Although the vitamin D results of the case group were lower, no statistically significant difference was found between the patient groups (p= 0.179). It was determined that there was a statistically significant relationship between the status of having chronic diseases and the case-control group. Persons with chronic diseases constitute 70.7% of the case group and 29.3% of the control group, while persons without chronic diseases constitute 35.6% of the case group and 64.4% of the control group (p= 0.001). While 14.6% of those with chronic disease had mild 34.1% and 22.0% had a critical illness; 23.7% of those without chronic disease had mild 6.8%, severe 5.1% had critical illness. In the study, the rate of severe or critical illness was found to be higher in those with chronic diseases than those without. The severe and critical patient group had higher CRP, Ferritin and D-dimer levels compared to the mildly severe patient group; It was observed that the lymphocyte level was lower (p< 0.05). The rate of severe and critical illness was found to be higher in those who partially pay attention to hand hygiene and mask rules (p< 0.05). Conclusion: Laboratory parameters such as CRP, ferritin, D-dimer and lymphocyte values were found to be significant predictors that could help in estimating the severity of the disease. Although it was lower in the case group, it was observed that there was a deficiency in vitamin D levels in both groups and insufficient doses of supplements were taken. In the study, it was observed that transmission was more common in social environments such as family and friends.