Risk stratification of hospitalized COVID-19 patients through comparative studies of laboratory results with influenza
Abstract
Background: The outbreak of coronavirus disease 2019 (COVID-19) in December 2019 overlaps with the flu season. Methods: We compared clinical and laboratory results from 719 influenza and 973 COVID-19 patients from January to April 2020. We compiled laboratory results from the first 14 days of the hospitalized patients using parameters that are most significantly different between COVID-19 and influenza and hierarchically clustered COVID-19 patients. Findings: Compared to influenza, patients with COVID-19 exhibited a continued increase in white blood cell count, rapid decline of hemoglobin, more rapid increase in blood urea nitrogen (BUN) and D-dimer, and higher level of alanine transaminase, C-reactive protein, ferritin, and fibrinogen. COVID-19 patients were sub-classified into 5 clusters through a hierarchical clustering analysis. Medical records were reviewed and patients were risk stratified based on the clinical outcomes. The cluster with the highest risk showed 27 8% fatality, 94% ICU admission, 94% intubation, and 28% discharge rates compared to 0%, 38%, 22%, and 88% in the lowest risk cluster, respectively. Patients in the highest risk cluster had leukocytosis including neutrophilia and monocytosis, severe anemia, increased red blood cell distribution width, higher BUN, creatinine, D-dimer, alkaline phosphatase, bilirubin, and troponin. Interpretation: There are significant differences in the clinical and laboratory courses between COVID-19 and influenza. Risk stratification in hospitalized COVID-19 patients using laboratory data could be useful to predict clinical outcomes and pathophysiology of these patients. (C) 2020 The Author(s). Published by Elsevier Ltd.
Other
original_citation: Mei Y, Weinberg SE, Zhao LH, Frink A, Qi C, Behdad A, Ji P. Risk stratification of hospitalized COVID-19 patients through comparative studies of laboratory results with influenza. Eclinicalmedicine. 2020;26:8.
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Additional details
- PMID
- 33089115
- The roles of mDia2 in membrane remodeling and organelle clearance during reticulocyte formation R01DK124220
- National Institute of Diabetes and Digestive and Kidney Diseases
- The Role of mDia1 in the Aberrant Innate Immune Signaling in del(5q) Myelodysplastic Syndromes CA140119
- United States Department of Defense
- The roles of mDia2 in hematopoietic stem and progenitor cell engraftment and migration 5R01HL148012
- National Heart Lung and Blood Institute (NHLBI)
- Created
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2020-09When the item was originally created.