Association of Clinical Characteristics, Hematological Indices, and Acute Inflammatory Markers in Hospitalized COVID-19 Patients with Disease Severity and Mortality: A Single-center Retrospective Study.

Abstract

Objective: To determine clinical and laboratory predictors of disease severity and mortality among patients with COVID-19 admitted to a tertiary care center in Saudi Arabia.

Methods: This retrospective cohort study included patients with laboratory-confirmed SARS-CoV-2 infection admitted to King Fahd Hospital of the University, Al Khobar, Saudi Arabia, between May and August 2020. Disease severity was defined based on intensive care unit (ICU) admission. Demographic, clinical, and laboratory data were extracted from the patients' electronic medical records and the laboratory information system.

Results: The study included 207 patients (mean age: 51 ± 16 years; male: 72%), of which 56 were severe cases. Compared to non-severe patients, severe patients had significantly higher white blood cell count (9.3 K/μl vs. 7.1 K/μl; P < 0.001), median absolute neutrophil count (6.2 vs. 4.4 K/μl; P = 0.003), absolute lymphocyte count (1.4 K/μl vs. 1.0 K/μl; P = 0.002); neutrophil-to-lymphocyte ratio (5.6 vs. 3.2; P < 0.001), median D-dimer (1.0 vs. 0.6 μg/ml; P < 0.001), median C-reactive protein (8.7 vs. 2.9 mg/dl; P < 0.001), and prothrombin time (14.1 vs. 13.6 seconds; P = 0.003). Similarly, compared to survivors, non-survivors had significantly higher median absolute neutrophil count (6.9 K/μl vs. 4.8 K/μl; P = 0.016), neutrophil-to-lymphocyte ratio (6.9 vs. 3.5; P < 0.001), median D-dimer (1.6 vs. 0.6 μg/ml; P = 0.005), and median C-reactive protein (11.7 vs. 3.1 mg/dl; P < 0.001). However, in the multivariable analysis, none of the laboratory parameters remained independently associated with disease severity or mortality.

Conclusion: This study found that among hospitalized COVID-19 patients in Saudi Arabia, several clinical and laboratory markers were associated with disease severity and mortality in univariable analyses; however, no independent predictors were identified after adjustment. These findings highlight the complexity of COVID-19 progression and the need for cautious interpretation of laboratory markers in clinical decision-making.