PROGNOSTIC SIGNIFICANCE OF CLINICAL AND LABORATORY FINDINGS IN THE NEW CORONAVIRUS INFECTION COVID-19

Abstract

The new coronavirus infection COVID-19 is characterized by high mortality. The aim of the study was to establish the role of gender, age, concomitant diseases, shifts in laboratory findings in predicting fatal outcome in COVID-19 patients. The study was conducted on the basis of emergency medical care hospital (Cheboksary). 182 case histories of COVID-19 patients who underwent inpatient treatment were analyzed, 82 of whom died. The frequency of outcomes in different clinical conditions and laboratory shifts were analyzed, the relative risk (RR) of lethal outcome and its confidence interval were calculated. Mortality is naturally associated with the number of points on the NEWS 2 scale, the extent of pulmonary tissue involvement, no connection with gender was found. The prognostic value of acute kidney injury (RR – 2.57), chronic kidney disease (RR – 1.47), arterial hypertension (RR – 3.04), coronary heart disease (RR – 2.60), chronic nonspecific lung diseases (RR – 1.53), elderly and senile age (RR – 2.84, HR – 4.90), obesity of II-III degrees (RR – 1.97), body weight deficit (RR – 1.82) is shown. The ROC analysis method determined the levels of C-reactive protein in the blood (> 25 mg/l, RR – 3.2), an increase in procalcitonin (RR – 3.80), D-dimer (> 562.8 ng/ml, RR – 3.15), leukocytes (> 9.52×109/l, RR – 2.22), lymphocytes (< 1.15×109/l, RR – 2.04), interleukin-6 (> 13.2 pg/ml, RR – 3.38), fibrinogen (> 6.4 g/l, RR – 1.57), creatinine (> 91.8 mmol/l, RR – 1.95), lactate dehydrogenase (> 558 mmol/l, RR – 2.28), glomerular filtration rate (GFR < 63.8 ml/min / 1.73 m2, RR – 2.55), going beyond which significantly increases the risk of fatal outcome. Hence, along with the known factors in the high-risk group, it is necessary to take into account a specific body mass index, age group, renal function indicators and a number of inflammatory changes in the blood.