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Indicators of clinical and biochemical blood tests in patients with the extremely severe course of the novel coronavirus infection COVID-19

DOI: https://doi.org/10.29296/25877305-2022-07-09

Professor R. Abdullaev(1), MD; O. Komissarova(1, 3), MD; M. Rybka2, MD;
Yu. Berezovsky(1)
1-Central Research Institute of Tuberculosis, Ministry of Education and Science
of Russia, Moscow
2-A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia, Moscow
3-N.I. Pirogov Russian National Research Medical University, Ministry of Health
of Russia, Moscow

The indicators of clinical and biochemical blood tests were analyzed in 54 patients with the extremely severe course of the novel coronavirus infection (NCI) COVID-19 who had died in the intensive care unit. It was established that >50% of the patients with the extremely severe NCI COVID-19 had anemia, as suggested by the significantly low levels of hemoglobin and hematocrit than in healthy people. The mean values of mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red blood cell distribution width did not differ substantially from those in healthy people. The study of the indicators of biochemical blood tests showed that the patients with the extremely severe course of NCI had a pronounced systemic inflammatory response. This was evidenced by higher C-reactive protein (CRP) and procalcitonin (PCT) levels in all the patients than in healthy people (a maximum of CRP was 478.7 mg/l, that of PCT was 22.7 ng/ml). The presence of a pronounced systemic inflammatory reaction was also suggested by a lower albumin level in the majority (88.9%) of patients (the minimum value was 17.3 g/l). The enhanced activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in >50% of the patients indicated impairments in the morphofunctional state of the liver (the maximum value of ALT was as much as 2608 U/l; that of AST was 5653 U/l). The majority (74.1%) of patients without concomitant diabetes mellitus in their history were observed to have an increase in glucose levels compared with healthy people (a maximum ranged up to 21.8 mmol/l). Most patients were found to have elevated levels of creatinine and urea in 68.5% and 88.9% of cases, respectively. At the same time, the maximum value of creatinine was 514 µmol/l; that of urea was 50.1 mmol/l. Impaired electrolyte metabolism was observed only in one-fourth of patients.

infectious diseases
novel coronavirus infection COVID-19
extremely severe course
clinical blood test indicators
biochemical blood test indicators

  1. Abdullaev R., Komissarova O. Laboratory indicators of coronavirus infection COVID-19. Vrach. 2020; 31 (5): 3–6 (in Russ.). DOI: 10.29296/25877305-2020-05-01
  2. Glybochko P., Fomin V., Moiseev S. et al. Clinical outcomes of patients with COVID-19 admitted for respiratory support to the intensive care units in Russia. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther. 2020; 29 (3): 25–36 (in Russ.). DOI: 10.32756/0869-5490-2020-3-25-36
  3. Allouche A., Amar J., Khadija E. et al. Hematological changes in COVID-19 and their association with the severity of the disease. Eur Respir J. 2021; 58 (suppl 65): PA3881. DOI: 10.1183/13993003.congress-2021.PA3881
  4. Basina B., Bielosludtseva K., Pertseva T. et al. C-reactive protein (CRP) at admission: is it really usefull in COVID-19 pneumonia? Eur Respir J. 2021; 58 (suppl 65): PA654. DOI: 10.1183/13993003.congress-2021.PA654
  5. Basina B., Bielosludtseva K., Pertseva T. et al. Fibrinogen like the predictor of COVID-19 pneumonia progression. Eur Respir J. 2021; 58 (suppl 65): PA517. DOI: 10.1183/13993003.congress-2021.PA517
  6. Bhatraju P.K., Ghassemieh B.J., Nichols M. et al. Covid-19 in critically ill patients in the Seattle Region – Case Series. N Engl J Med. 2020; 382 (21): 2012–22. DOI: 10.1056/NEJMoa2004500
  7. Kozlov V.A., Tikhonova E.P., Savchenko A.A. et al. Klinicheskaya immunologiya. Prakticheskoe posobie dlya infektsionistov. Krasnoyarsk: Polikor, 2021; 563 c. (in Russ.). DOI: 10.17513/np.438
  8. Kudlay D., Shirobokov Ya., Gladunova E. et al. Diagnosis of COVID-19. Methods and problems of virus SARS-CoV-2 detection under pandemic conditions. Vrach. 2020; 31 (8): 5–10 (in Russ.). DOI: 10.29296/25877305-2020-08-01
  9. Chen H., Guo J., Wang C. et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020; 395 (10226): 809–15. DOI: 10.1016/S0140-6736(20)30360-3
  10. Guan W.J., Ni Z.Y., Hu Y. et al. China Medical Treatment Expert Group for COVID-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382: 1708–20. DOI: 10.1056/NEJMoa2002032.
  11. Herold T., Jurinovic V., Arnreich C. et al. Elevated levels of interleukin-6 and CRP predict the need for mechanical ventilation in COVID-19. J Allergy Clin Immunol. 2020; 146 (1): 128–136.e4. DOI: 10.1016/j.jaci.2020.05.008
  12. Frent S.-M., Bobu E., Pleava R. et. al.Factors associated with poor glycemic control in patients hospitalised for COVID-19. Eur Respir J. 2021; 58 (suppl 65): PA526. DOI: 10.1183/13993003.congress-2021.PA526
  13. Lippi G., Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta. 2020; 505: 190–1. DOI: 10.1016/j.cca.2020.03.004
  14. Wang D., Hu B., Hu C. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323 (11): 1061–9. DOI: 10.1001/jama.2020.1585
  15. Lippi G., Mattiuzzi C. Hemoglobin value may be decreased in patients with severe coronavirus disease 2019. Hematol Transfus Cell Ther. 2020; 42 (2): 116–7. DOI: 10.1016/j.htct.2020.03.001
  16. Liu Y., Yang Y., Zhang C. et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020; 63 (3): 364–74. DOI: 10.1007/s11427-020-1643-8
  17. Patil S.V., Patil R., Gondhali G. Effect of hyperglycemia on post-COVID-19lung fibrosis: study of 600 cases in tertiary care setting in India. Eur Respir J. 2021; 58 (suppl 65): PA3777. DOI: 10.1183/13993003.congress-2021.PA3777
  18. Wu Ch.-T., Lidsky P.V., Xiao Y. et al. SARS-CoV-2 infects human pancreatic b cells and elicits b cell impairment. Cell Metabol. 2021; 33 (8):1565–1576.e5. DOI: 10.1016/j.cmet.2021.05.013
  19. Zippi M., Fiorino S., Occhigrossi G., Hong W. Hypertransaminasemia in the course of infection with SARS-CoV-2: incidence and pathogenetic hypothesis. World J Clin Cases. 2020; 8 (8): 1385–90. DOI: 10.12998/wjcc.v8.i8.1385