KUMJ | VOL. 21 | NO. 4 | ISSUE 84 | OCTOBER - DECEMBER, 2023

Comparative Analyses of Clinical, Laboratory, and Radiological Findings between COVID-19 Deceased and Recovered Patients
Shrestha MR, Basnet A, Joshi P, Bhat DS, Maharjan R, Thapa R, Joshi RD, Maharjan R, Jha RK

Abstract:
Background Understanding the coronavirus disease 2019 (COVID-19)-specific indices has become important with increasing cases of COVID-related in-hospital mortality. Objective This case-control study compared clinical, laboratory, and radiological findings between deceased and recovered COVID-19 patients and identified the significant biomarkers associated with deceased patients. Method An analysis of clinical, laboratory, and radiological findings of COVID-19 patients admitted to the COVID-dedicated wards of Nepal Armed Police Force Hospital between March and December 2021 was performed using SPSS version 17.0, with statistical significance considered at p < 0.05. Result A total of 187 COVID-19 patients, comprising deceased [n=95, median (interquartile range, IQR) age: 66 (53–76) years, male: 61 (64.2%) (p=0.024)] and recovered [n=92, median (IQR) age: 51 (38–61) years, male: 44 (47.8%)], were included in the study. Compared to recovered COVID-19 patients, deceased patients had increased median respiratory (20 versus 29.5 breaths/minute) and pulse (83 vs. 86 beats/minute) rates; multiple co-morbidities (≥ 2) (11.9% vs. 32.6%) (p < 0.001); significantly (p < 0.05) lowered alkaline phosphatase (ALP), total protein (TP), albumin, lymphocytes, monocytes, eosinophil, hemoglobin and significantly (p < 0.05) elevated glucose, lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate aminotransferase (AST), leucocytes, neutrophils, D-dimer and C-reactive protein (CRP); and chest abnormalities including bilateral (p < 0.001), peripheral (p < 0.001) interstitial (p < 0.001) and ground glass opacity (GGO) (p=0.002). Conclusion Elderly, male sex, increased respiratory and pulse rate, presence of multiple co- morbidities, lowered levels of ALP, TP, albumin, lymphocytes, monocytes, eosinophils, hemoglobin, elevated levels of glucose, LDH, ALT, AST, leucocytes, neutrophils, D-dimer, CRP, and chest X-rays showing bilateral, peripheral interstitial and GGO abnormalities were the significant indices associated with deceased COVID-19 patients.
Keyword : Biomarkers, Comorbidity, COVID-19, Laboratory, Radiology, Signs symptoms, Vitals