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

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.