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Brief ReportBrief Report

A Review of Clinical and Laboratory Predictors of Severe COVID-19 Disease

Edward Kwon, Nathan Whitlow and Alexander Reed
The Journal of the American Board of Family Medicine February 2021, 34 (Supplement) S186-S191; DOI: https://doi.org/10.3122/jabfm.2021.S1.200165
Edward Kwon
From the Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA (All authors).
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Nathan Whitlow
From the Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA (All authors).
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Alexander Reed
From the Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA (All authors).
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Article Figures & Data

Figures

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  • Figure 1a.
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    Figure 1a.

    Multi-focal, peripheral, rounded ground glass opacities seen on the right upper and adjacent lower lobes (arrows) are commonly reported features of COVID-19.

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    Figure 1b.

    The multi-focal subsegmental consolidations, with ill-defined ground-glass opacities, of the posterior lower lobes (arrows), are nonspecific.

Tables

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    Table 1.

    Patient Laboratory Values

    LabDay 0Day 1Day 2Day 3
    WBC × 103/µL5.55.25.54.4
    Neutrophils abs, 103/µL4.14.13.82.6
    Neutrophil, %74.478.168.759.3
    Lymphocyte abs, 103/µL0.80.61.01.1
    Lymphocyte, %15.111.618.725
    Platelet, 103/µL127122155182
    C-reactive protein, mg/dL8.159.015.05
    Erythrocyte sedimentation rate, mm/hr556874
    Ferritin, ng/mL169817231880
    D-dimer, µg/mL0.701.11
    LDH, U/L321321316
    Albumin, g/dL4.14.13.63.8
    Prothrombin time, s14.0
    Aspartate aminotransferase, U/L38333142
    Alanine aminotransferase, U/L31303253
    Creatine kinase, U/L46505149
    Interluekin-6, pg/mL55.6
    High-sensitivity troponin, ng/L6.46.86.1
    • WBC, white blood cells; LDH, lactate dehydrogenase.

    • View popup
    Table 2.

    Characteristics of Included Studies

    StudyNation of OriginCOVID-19 Comparison GroupsStudy DesignSample Size N
    Mo et al.4ChinaRefractory vs Non-refractoryRetrospective cohort155
    Wu et al.6ChinaARDS vs No ARDSRetrospective cohort201
    Zhou et al.7ChinaNon-survivor vs SurvivorRetrospective cohort191
    Zhang et al.8ChinaSevere vs Non-severe COVID-19Retrospective cohort140
    Du et al.9ChinaNon-survivor vs SurvivorProspective cohort179
    Li et al.10ChinaNon-survivor vs SurvivorRetrospective cohort102
    • ARDS, acute respiratory distress syndrome; vs, versus.

    • View popup
    Table 3.

    COVID-19 Clinical and Laboratory Indices

    Co-Morbidities and Laboratory findingsNon-Survivor vs Survivor7Refractory vs Non-refractory disease4ARDS vs No ARDS6Severe vs Non-severe disease8Non-Survivor vs Survivor10Non-Survivor vs Survivor9
    Hypertension48% vs 23%No significant difference27.4% vs 13.7%No significant differenceNo significant difference61.9% vs 28.5%
    Diabetes mellitus31% vs 14%12% vs 3%19% vs 5.1%No significant differenceNo significant differenceNo significant difference
    Coronary artery or cardiovascular disease24% vs 1%14% vs 0%No significant differenceNo significant difference13% vs 2%57.1 vs 10.8%
    Respiratory disease or COPD7% vs 1%NANANo significant differenceNo significant differenceNA
    Leukocytes, 109/L9.8 vs 5.2No significant difference8.32 vs 5.02 109/mL**5.3 vs 4.59.1 vs 5.58.9 vs 5.1
    Lymphocytes, 109/L0.6 versus 1.1No significant difference0.67 vs 1.08 109/mL**0.7 vs 0.80.5 vs 0.90.7 vs 0.8
    Platelets, 109/L165.5 vs 220159 vs 179178 vs 187 × 109/mL**NA113 vs 206.5NA
    ESRNANo significant differenceNo significant differenceNANANA
    CRP, mg/LNA46 vs 2383 vs 23447.6 vs 28.778.7 vs 25.486.4 vs 36
    LDH, U/L521 vs 253.5293 vs 241396 vs 257NA569 vs 272NA
    Ferritin1435.3 vs 503.2 µg/LNA1029 vs 457 ng/mLNANANA
    D-dimer, µg/mL5.2 vs 0.6No significant difference1.16 vs 0.520.4 vs 0.22.1 vs 0.71.1 vs 0.5
    PT, seconds12.1 vs 11.4NA11.7 vs 10.6NA14.9 vs 14.1No significant difference
    Interleukin-6, pg/mL11.0 vs 6.3NA7.39 vs 6.29NA48.4 vs 4.2NA
    Procalcitonin, ng/mL0.1 vs 0.1No significant differenceNo significant difference0.1 vs 0.050.19 vs 0.050.1 vs 0.1
    • ARDS, acute respiratory distress syndrome; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; LDH, lactate dehydrogenase; PT, prothrombin time; NA, not addressed; vs, versus; COPD, chronic obstructive pulmonary disease.

    • *Clinical significance was defined by P < .05. Percentages are reported as prevalence of the co-morbidity within each respective group. Laboratory findings were specified as values on admission for all 5 retrospective cohort studies.

    • ** We believe 109/mL units are reflected as an error and should reflect 109/L. We have contacted the referenced journal to inquire.

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The Journal of the American Board of Family  Medicine: 34 (Supplement)
The Journal of the American Board of Family Medicine
Vol. 34, Issue Supplement
February 2021
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A Review of Clinical and Laboratory Predictors of Severe COVID-19 Disease
Edward Kwon, Nathan Whitlow, Alexander Reed
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S186-S191; DOI: 10.3122/jabfm.2021.S1.200165

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A Review of Clinical and Laboratory Predictors of Severe COVID-19 Disease
Edward Kwon, Nathan Whitlow, Alexander Reed
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S186-S191; DOI: 10.3122/jabfm.2021.S1.200165
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