Laboratory Features of Hospitalised Patients with COVID-19 in Jersey, UK.

Abstract

COVID-19 is an acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, more than 550 million cases and 6 million deaths have been reported worldwide. This study investigated the laboratory features in hospitalised patients with COVID-19 and determined risk factors for in-hospital mortality. This retrospective observational study included laboratory results of confirmed cases of hospitalised patients with SARS-CoV-2 infection in Jersey (UK) between March-December 2020 (subject to inclusion criteria), and a control group. Furthermore, COVID-19 patients were split into two sub-groups, based on outcome (non-survivors vs. survivors). Logistic regression was used to determine risk factors for in-hospital mortality. A total of 81 COVID-19 cases and 100 controls were included in this study. In the COVID-19 group, 59.3% of subjects were male, and the overall mortality was 33.3%. The main laboratory changes were the following: 95.1% of patients presented with raised C-reactive protein (p<0.001), 85% showed increased fibrinogen (p<0.001), 70% had prolonged prothrombin time (p=0.014), 51.9% suffered from lymphopenia (p<0.001), 42% had elevated gamma glutamyl transferase (p=0.011) and 35.8% demonstrated raised creatinine concentration (p=0.002). Non-survivors were older than survivors (median age: 82 vs. 74 years, p=0.003) with substantial lymphopenia (p=0.018), high creatinine level (p=0.009), and leukocytosis (p=0.018). Increased in-hospital mortality risk was 6.7-fold in patients presenting with a lymphocyte count <0.85 x10⁹/L, 5.3-fold with red blood cell distribution width >14%, 4.9-fold with white cell count >9.5 x10⁹/L, and 3.3-fold for those presenting with creatinine >100 μmol/L. Age ≥82 years was significantly associated with death, and male gender a risk factor for hospital admission in COVID-19. These results demonstrate that routine haematology and biochemistry tests may allow for risk-stratification of hospitalised patients with COVID-19.