Risk Stratification of Hospitalized COVID-19 Patients Through Comparative Studies of Laboratory Results with Influenza
Abstract
Background: The outbreak of coronavirus disease 2019 (COVID-19) in December 2019 overlaps with the flu season. Methods: We compared clinical and laboratory results from 719 influenza and 973 COVID-19 patients from January to April 2020. We compiled laboratory results from the first 14 days of the hospitalized patients using parameters that are most significantly different between COVID-19 and influenza and hierarchically clustered COVID-19 patients. Findings: Compared to influenza, patients with COVID-19 exhibited a continued increase in white blood cell count, rapid decline of hemoglobin, more rapid increase in blood urea nitrogen (BUN) and D-dimer, and higher level of alanine transaminase, C-reactive protein, ferritin, and fibrinogen. COVID-19 patients were sub-classified into 5 clusters through a hierarchical clustering analysis. Medical records were reviewed and patients were risk stratified based on the clinical outcomes. The cluster with the highest risk showed 27-8% fatality, 94% ICU admission, 94% intubation, and 28% discharge rates compared to 0%, 38%, 22%, and 88% in the lowest risk cluster, respectively. Patients in the highest risk cluster had leukocytosis including neutrophilia and monocytosis, severe anemia, increased red blood cell distribution width, higher BUN, creatinine, D-dimer, alkaline phosphatase, bilirubin, and troponin. Interpretation: There are significant differences in the clinical and laboratory courses between COVID-19 and influenza. Risk stratification in hospitalized COVID-19 patients using laboratory data could be useful to predict clinical outcomes and pathophysiology of these patients.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 31, 2020
- Accession Number
- AD1113002
Entities
People
- Adam Frink
- Amir Behdad
- Chao Qi
- Lihui Zhao
- Peng Ji
- Samuel E Weinberg
- Yang Mei
Organizations
- Northwestern University