Research Article

Blood Features Associated with Viral Infection Severity: An Experience from COVID-19-Pandemic Patients Hospitalized in the Center of Iran, Yazd

Table 1

(a) Descriptive information and biochemical analysis (related to organ function; kidney, heart, and liver) of included patients (aged 18–92 years) admitted to COVID-19 referral treatment center, Shahid Sadoughi Hospital, Yazd, Iran, (n = 466), and multivariate analysis of risk factors associated with infection severity and prediction of death outcome. (b) Hematological features of included patients referred to COVID-19 referral center, Shahid Sadoughi Hospital, Yazd, Iran (n = 466 people), and multivariate analysis of risk factors that may be related to infection severity and prediction of death outcome. (c) Laboratory indexes of included patients admitted to COVID-19 referral treatment center, Shahid Sadoughi Hospital, Yazd, Iran (n = 466), and multivariate analysis of risk factors that may be associated with viral infection severity and death outcome in patients.

(a)

VariablesGroupsAll cases (mean, years) valueRecovered (mean, years)Deceased (mean, years)ORMultivariate analysis of risk factors for deceased (95% CI) value

Age (years)Male57.68 (18–92)0.00054.39 (20–92)60.84 (18–87)
Female41.32 (18–92)0.00035.45 (18–84)58.17 (18–92)
Total46.410.00039.859.43

All cases (%)Recovered (%)Deceased (%)

SexMale145 (31)71 (49)74 (51)2.9901.983–4.500.000
Female321 (68.9)238 (74.1)83 (25.9)
Total466 (100)0.000309 (66.31)157 (33.691)

Age (years) (men)18–4018 (12.2)13 (72.30)5 (27.7)0.267
41–6047 (32.4)24 (51.1)23 (48.90)2.6250.478–14.4280.04
61–10080 (55.3)0.05031 (37.75)49 (62.25)4.600.87–24.3160.031

Age (years) (women)18–40207 (64.5)191 (92.4)16 (7.6)0.804
41–6043 (13.4)25 (59.5)17 (40.5)1.1900.301–4.7030.068
61–10071 (22.1)0.00024 (33.8)47 (66.2)3.4270.913–12.8710.000

VariablesCutoffsaAll cases (%) valuebRecovered (%)Deceased (%)ORcMultivariate analysis of risk factors for deceased (95% CI) value

FBS<12656 (10)23 (46)27 (54)
≥126410 (90)0.001285 (68.7)130 (31.3)2.5741.422–4.6590.002

Creatinine≤1.4405 (86.9)293 (72.3)112 (27.7)
>1.461 (13.1)0.00016 (26.2)45 (73.8)7.3583.995–13.5500.000

Urea≤40180 (38.6)147 (81.7)33 (18.3)
>40286 (61.4)0.000162 (56.6)124 (43.4)3.412.187–5.3160.000

SGOT≤40258 (44.6)191 (74)67 (26)
>40208 (55.4)0.000118 (56.7)90 (43)2.1741.471–3.2140.000

SGPT≤56358 (76.8)251 (70.1)107 (29.9)
>56108 (23.2)0.00258 (53.7)50 (46.3)2.0221.301–3.1420.002

Alkaline-P≤12879 (17)57 (72.2)22 (27.8)
>128387 (83)0.228252 (65.1)135 (34.9)1.5180.842–2.7390.166

Bilirubin D (mg/dL)≤0.2291 (62.4)206 (70.8)85 (29.2)
>0.2175 (37.6)0.008103 (58.9)72 (41)5.6051.602–19.6120.007

Hypocalcemia<8.4193 (41.4)104 (53.9)89 (46.1)2.5671.731–3.8080.000
≥8.4272 (58.4)0.000204 (75)68 (25)

Hyperkalemia≤5414 (88.8)297 (71.7)117 (28.3)
>551 (10.9)0.00011 (21.6)40 (78.4)9.2314.581–18.6020.000

CPK (U/L)≤200243 (52.1)163 (67.10)80 (32.90)
>200223 (47.9)0.000146 (65.50)77 (34.50)1.0750.732–1.5780.714

(b)

VariablesCutoffsdAll cases (%) valueeRecovered (%)Deceased (%)ORfMultivariate analysis of risk factors for deceased (95% CI) value

Hemoglobin<12201 (43.1)135 (67.20)66 (32.8)0.9350.634–1.3790.734
≥12265 (56.9)0.000174 (65.70)91 (34.3)

Anemiag<3.559 (12.5)30 (50.8)29 (49.2)2.1071.214–3.6580.008
≥3.5407 (87.3)0.006279 (68.6)128 (31.4)

Neutrophiliah≤8288 (61.8)224 (77.8)64 (22.2)
>8178 (38.2)0.00085 (47.8)93 (52.2)3.8132.086–6.9720.000

Lymphocytopeniai<1244 (52.4)129 (52.9)115 (47.1)6.6593.789–11.7050.001
≥1222 (47.6)0.000189 (81.1)42 (18.9)

Thrombocytopeniaj<140132 (28.3)63 (47.7)69 (52.3)3.0622.013–4.6570.000
≥140334 (71.7)0.000246 (73.7)88 (26.3)

PTk≤13281 (60.3)215 (76.5)66 (23.5)
>13185 (39.7)0.00094 (50.8)91 (49.20)4.4632.648–7.5220.000

Blood groupsA−19 (4.1)12 (3.9)7 (4.5)1.3610.501–3.6990.546
A+105 (22.5)70 (22.7)35 (22.3)1.1670.678–2.0090.578
AB−3 (0.6)2 (0.6)1 (0.6)1.1670.103–13.2190.901
AB+19 (4.1)10 (3.20)9 (5.7)2.1000.796–5.5420.134
B−18 (3.9)10 (3.2%)8 (5.1)1.8670.688–5.0610.220
B+139 (29.8)93 (30.1)46 (29.3)1.1540.696–1.9130.578
O−23 (4.9)14 (4.5)9 (5.7)1.5000.603–3.7340.384
O+140 (30)98 (31.7)42 (26.8)0.801

(c)

VariablesCutoffslAll cases (%) valuemRecovered (%)Deceased (%)ORnMultivariate analysis of risk factors for deceased (95% CI) value

N/L ratioo≤9187 (40.1)227 (81.4)52 (18.6)
>9279 (59.9)0.00082 (43.9)105 (56.1)5.593.682–8.4850.000

D-Dimer (ng/mL)p≤200206 (44.2)144 (69.90)62 (30.10)
>200260 (55.8)0.144165 (63.50)95 (36.50)1.3370.905–1.9760.144

CRP (N/P)q050 (10.7)45 (90)5 (10)0.005
156 (12)37 (66.10)19 (33.90)4.6221.574–13.5670.000
2236 (50.6)143 (66.60)93 (39.40)5.8532.241–15.2880.004
3124 (26.6)0.00084 (67.70)40 (32.30)4.7141.580–11.6230.003

≤30087 (18.7)82 (94.3)5 (5.7)
>300379 (81.3)0.000227 (59.9)152 (40.1)10.9814.35–27.7190.000

Het/Albs≤10277 (59.4)206 (74.4)71 (25.6)
>10189 (40.6)0.000103 (54.5)86 (45.5)2.4231.635–3.5900.000

aPatient data were divided into two categories: those who died in the hospital and those who were discharged from the hospital, and then the information was analyzed by logistic regression to identify possible potential risk factors. The cutoffs were selected according to the normal range of biochemical markers. bPatients were divided into two categories: those who died in the hospital and those who were discharged from the hospital, and then their frequencies in each group were analyzed and compared. cThe logistic regression analysis was done to estimate which indicator can be related to the occurrence of death in patients: biochemical cutoffs as independent variables and the outcome of death as a dependent variable. ≤: the serum ranges equal to or less than the normal reference range. ≥: the serum ranges equal to or more than the normal reference range. FBS: fasting blood sugar; SGOT: serum glutamate-pyruvate aminotransferase; GPT: serum glutamate-oxaloacetate aminotransferase; CPK: creatine kinase. dPatients were divided into subgroups based on specific cutoff of each variable that showed associations with the deceased outcome including hemoglobin (cutoff <12), anemia (cutoff <3.5), neutrophilia (cutoff >8), lymphocytopenia (cutoff <1), thrombocytopenia (cutoff <140), prothrombin time (PT) (cutoff <13), and blood groups (A−/A+, AB−/AB+, B−/B+, and O−/O+). ePatients were divided into two categories: those who died in the hospital and those who were discharged from the hospital, and then their frequencies in each group were analyzed and compared. fThe logistic regression analysis was done to estimate which indicator can predict the occurrence of death in patients: hematological cutoffs as an independent variable and the outcome of death as a dependent variable. gCases with RBC count <3.5 × 1012/L. hCases with neutrophil count >8 × 103/µL. iCases with lymphocyte count <1 × 103/µL. jCases with platelet count <140 × 103/µL. kCases with prothrombin time (sec). lPatients were divided into subgroups based on a specific cutoff of each variable that showed associations with the deceased outcome including N/L ratio (cutoff >9), D-dimer (cutoff >200), CRP (cutoff∼ +1, +2, +3), ferritin (cutoff >300), and Het/Alb index (cutoff >10). mPatients were divided into two categories: those who died in the hospital and those who were discharged from the hospital, and then their frequencies in each group were analyzed and compared. nThe logistic regression analysis was done to estimate which indicator can be related to the occurrence of death in patients: biomarker cutoff as an independent variable and the outcome of death as a dependent variable. N/L: neutrophil/lymphocyte; CRP: C-reactive protein; Het/Alb: hematocrit/albumin. oCases with N/L ratio >9; pCases with D-Dimer (ng/mL) >200; qCases with CRP(N/P) (+1, +2, +3); rCases with Ferritin >300; sHet/Alb ratio >10.