Predicting Severity and Intrahospital Mortality in COVID-19: The Place and Role of Oxidative Stress

Medientyp: E-Artikel
Titel: Predicting Severity and Intrahospital Mortality in COVID-19: The Place and Role of Oxidative Stress
Beteiligte: Cekerevac, Ivan; Turnic, Tamara Nikolic; Draginic, Nevena; Andjic, Marijana; Zivkovic, Vladimir; Simovic, Stefan; Susa, Romana; Novkovic, Ljiljana; Mijailovic, Zeljko; Andjelkovic, Marija; Vukicevic, Vladimir; Vulovic, Tatjana; Jakovljevic, Vladimir
Erschienen: Hindawi Limited, 2021
Erschienen in: Oxidative Medicine and Cellular Longevity
Sprache: Englisch
DOI: 10.1155/2021/6615787
ISSN: 1942-0994; 1942-0900
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Beschreibung: <jats:p>SARS-CoV-2 virus causes infection which led to a global pandemic in 2020 with the development of severe acute respiratory syndrome. Therefore, this study was aimed at examining its possible role in predicting severity and intrahospital mortality of COVID-19, alongside with other laboratory and biochemical procedures, clinical signs, symptoms, and comorbidity. This study, approved by the Ethical Committee of Clinical Center Kragujevac, was designed as an observational prospective cross-sectional clinical study which was conducted on 127 patients with diagnosed respiratory COVID-19 viral infection from April to August 2020. The primary goals were to determine the predictors of COVID-19 severity and to determine the predictors of the negative outcome of COVID-19 infection. All patients were divided into three categories: patients with a mild form, moderate form, and severe form of COVID-19 infection. All biochemical and laboratory procedures were done on the first day of the hospital admission. Respiratory (<jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M1"> <mi>p</mi> <mo><</mo> <mn>0.001</mn> </math> </jats:inline-formula>) and heart (<jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M2"> <mi>p</mi> <mo>=</mo> <mn>0.002</mn> </math> </jats:inline-formula>) rates at admission were significantly higher in patients with a severe form of COVID-19. From all observed hematological and inflammatory markers, only white blood cell count (<jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M3"> <mn>9.43</mn> <mo>±</mo> <mn>4.62</mn> </math> </jats:inline-formula>, <jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M4"> <mi>p</mi> <mo>=</mo> <mn>0.001</mn> </math> </jats:inline-formula>) and LDH (<jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M5"> <mn>643.13</mn> <mo>±</mo> <mn>313.3</mn> </math> </jats:inline-formula>, <jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M6"> <mi>p</mi> <mo>=</mo> <mn>0.002</mn> </math> </jats:inline-formula>) were significantly higher in the severe COVID-19 group. We have observed that in the severe form of SARS-CoV-2, the levels of superoxide anion radicals were substantially higher than those in two other groups (<jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M7"> <mn>11.3</mn> <mo>±</mo> <mn>5.66</mn> </math> </jats:inline-formula>, <jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M8"> <mi>p</mi> <mo><</mo> <mn>0.001</mn> </math> </jats:inline-formula>) and the nitric oxide level was significantly lower in patients with the severe disease (<jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M9"> <mn>2.66</mn> <mo>±</mo> <mn>0.45</mn> </math> </jats:inline-formula>, <jats:inline-formula> <math xmlns="http://www.w3.org/1998/Math/MathML" id="M10"> <mi>p</mi> <mo><</mo> <mn>0.001</mn> </math> </jats:inline-formula>). Using a linear regression model, TA, anosmia, ageusia, O2−, and the duration at the ICU are estimated as predictors of severity of SARS-CoV-2 disease. The presence of dyspnea and a higher heart rate were confirmed as predictors of a negative, fatal outcome. Results from our study show that presence of hypertension, anosmia, and ageusia, as well as the duration of ICU stay, and serum levels of O2− are predictors of COVID-19 severity, while the presence of dyspnea and an increased heart rate on admission were predictors of COVID-19 mortality.</jats:p>
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