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ORIGINAL ARTICLE
Year : 2021  |  Volume : 64  |  Issue : 6  |  Page : 306-311

The predictive and prognostic role of hematologic and biochemical parameters in the emergency department among coronavirus disease 2019 patients


1 Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
2 Division of Pediatric Surgery, Department of Surgery; Division of Trauma, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
3 Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
4 Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
5 Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City; Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan, Taiwan
6 Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan; Public Health Bureau, New Taipei City, Taiwan
7 Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City; School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan

Correspondence Address:
Dr. Jen-Tang Sun
Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjp.cjp_77_21

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Coronavirus disease 2019 (COVID-19) had caused a worldwide pandemic with public health emergencies since 2020. For the symptomatic patients, high mortality rate was observed if without timely and optimized management. In this study, we aimed to investigate the predictive and prognostic roles of hematologic and biochemical parameters obtained in the emergency department (ED) for COVID-19 patients. We conducted a retrospective study in a dedicated COVID-19 medical center, recruiting a total of 228 COVID-19 patients with 86 severe and 142 non-severe cases. Both the hematologic and biochemical parameters obtained in the ED upon arrival were analyzed to evaluate the association of the biomarkers with disease severity and prognosis among COVID-19 patients. Among these parameters, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, and D-dimer were significantly higher in the severe group than the non-severe one, whereas the platelet count and lymphocyte-to-monocyte ratio were significantly lower. Receiver operating characteristic curve analysis revealed that the areas under curve of CRP, PCT, LDH, ferritin, D-dimer, and NLR for differentiating the severity of COVID-19 were 0.713, 0.755, 0.763, 0.741, 0.733, and 0.683, respectively, whereas the areas under curve of CRP, PCT, LDH, ferritin, D-dimer, and NLR for differentiating the mortality of COVID-19 were 0.678, 0.744, 0.680, 0.676, 0.755, and 0.572, respectively. Logistic regression analysis revealed that CRP, PCT, LDH, ferritin, D-dimer, and NLR were independent indicators for prediction of severe COVID-19, and LDH and ferritin were independent factors associated with the mortality in COVID-19. In conclusion, higher CRP, PCT, LDH, ferritin, D-dimer, and NLR were associated with severe COVID-19, whereas higher LDH and ferritin were associated with the mortality in COVID-19. These findings could help early risk stratification in the ED and contribute to optimized patient management.


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