Evaluation of Biochemical Tests in Patients with Severe SARS-CoV 2 Infection and Need for Oxygen Therapy

Introduction: Since December 2019, when a cluster of pneumonia cases due to SARS-CoV-2 first appeared in China and then rapidly spread worldwide, the need for data on clinical but also paraclinical characteristics of patients with COVID-19 has been highlighted.

Method: Between April 15, 2022, and July 31, 2022, 2583 RT-PCR tests were performed in the Emergency Clinical County Hospital Saint Andrei Constanta. Of these 463 were positive, 223 patients were hospitalized in different wards and 70 had severe forms requiring oxygen therapy. The present study aimed to evaluate laboratory data of patients diagnosed with severe SARS-COV2 infection requiring oxygen therapy to detect any parameters associated with more severe forms and reserved prognosis according to previous published research.

Results: The patients in the study group were mostly from urban areas, had a mean age of 69.9 years (24-94), 59% were women, and 95.7% of them had associated comorbidities, (38.5% of them had 2 comorbidities and 30% even 3 comorbidities) the most common being hypertension (70%), diabetes mellitus (24.2%) and cardiovascular diseases (31.4%). In the group of patients analyzed showed increases in leukocyte count (48.5%), neutrophil count (52.9%) and decreases in lymphocyte count (72.8%), as well as a degree of anemia in 52.9% of patients. Increased values of inflammatory tests were also recorded: ESR (68.7%), CRP (77.6%), LDH (84%), Fibrinogen (59.3%). D dimers and ferritin were also detected with increased values in 85.7% and 84.2% of patients who had these parameters measured. Increases in urea (57.6%), creatinine (51.6%) and AST (51.6%) were detected but not in ALT. No notable changes in K, Na, AR were detected. Out of the total of 70 patients 45 patients received nasal tube oxygen therapy and the remaining 25 received bilevel positive airway pressure (BiPAP) ventilation. The death rate was 4.3% (3 patients died).

CONCLUSIONS: the majority of patients with severe COVID 19 who required hospitalization and oxygen therapy were elderly, had at least one associated comorbidity, high levels of inflammatory tests and D-dimer and ferritin, and tests showing hepatic, renal or pulmonary damage.