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10.1016/j.eclinm.2020.100475

http://scihub22266oqcxt.onion/10.1016/j.eclinm.2020.100475
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suck abstract from ncbi


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pmid33089115      EClinicalMedicine 2020 ; 26 (ä): 100475
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  • Risk stratification of hospitalized COVID-19 patients through comparative studies of laboratory results with influenza #MMPMID33089115
  • Mei Y; Weinberg SE; Zhao L; Frink A; Qi C; Behdad A; Ji P
  • EClinicalMedicine 2020[Sep]; 26 (ä): 100475 PMID33089115show ga
  • 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. FUNDING: National Institute of Diabetes and Digestive and Kidney Disease, Department of Defense, and National Heart, Lung, and Blood Institute.
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