Background: The pandemic of severe acute respiratory
syndrome by coronavirus 2 (SARS-CoV-2) is a multi-system
disease caused by a diffuse systemic process involving a
complex interaction of the inflammatory, immunological
and coagulative cascades. This study aims to identify the
most effective biomarkers to predict poor outcome in
intensive care unit (ICU) patients with severe COVID-19
disease.
Methods: A single-centre retrospective observational study
enrolled 69 deceased and 20 recovered patients treated in
the ICU of the General Hospital Gradiska in the period
from March 1, 2021. until April 1, 2022. We evaluated the
leukocytes (WBC), lymphocytes (LYM), neutrophils (NEU),
platelets (PLT), haemoglobin, neutrophil-lymphocyte ratio
(NLR), platelet lymphocyte ratio (PLR), and systemic
immune-inflammation index (SII). In addition, we
evaluated the IL-6, ferritin, CRP, D-dimer, magnesium, bili –
rubin and lactate dehydrogenase.
Results: Between deceased and recovered patients on
admission to the ICU, there was a significant difference between the following parameters: WBC x109/L [11.50
(8.86–14.75) vs. 9.40 (5.90–11.90), p =0.026]; NEU
x109/L [10.15 (7.81–12.74) vs. 8.60 (4.80–10.30)
p=0.022]; NLR [15.01 (10.60–24.33) vs. 9.45 (5.10–
14.90) p=0.02]; SII [3712 (2240–6543) vs. 1949
(993–3720) p=0.003]. The magnesium level increased
significantly over time in the patients who died, while the
haemoglobin level and platelet count decreased. ROC
analysis showed the following AUC values: WBC 0.774;
NEU 0.781; NLR 0.786; SII 0.776; D-dimer 0.741, and
bilirubin 0.713.
Conclusion: In this retrospective study WBC, NEU, NLR,
SII, D-dimer, and bilirubin determined at hospital
admission had a high value in predicting death among
patients with severe COVID-19.
