Evaluation of the Charlson Comorbidity Index and Laboratory Parameters as Independent Early Mortality Predictors in Covid 19 Patients

Abstract

Betül Cavuşoğlu Türker,1 Fatih Türker,2 Süleyman Ahbab,2 Emre Hoca,2 Ayşe Oznur Urvasızoğlu,2 Seher Irem Cetin,2 Hayriye Esra Ataoğlu2 1University of Health Sciences, Taksim Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey; 2University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, TurkeyCorrespondence: Fatih Türker, University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, Aksaray, Dr. Adnan Adıvar Cd. No: 9, Fatih, İstanbul, 34130, Turkey, Tel +905364721656, Fax +90 212 453 20 00, Email [email protected]: Purpose: Various parameters have been proposed to predict the outcome of patients with coronavirus disease. The aim of this study was to evaluate the utility of the age-adjusted CCI score and biochemical parameters for predicting outcomes for COVID-19 patients on admission.Patients and methods: A total of 511 patients were included in the study. Only swab or serological tests positive patients were included. The clinical characteristics of the patients were compared between survival and non-survival COVID-19 inpatients. Hemoglobin, platelet, sedimentation, creatinine, AST, ALT, LDH, CK, albumin, ferritin, lymphocyte, neutrophil, CRP (1– 5;5– 10;10– 20 × upper limit), procalcitonin (5– 10;10– 20; > 20 × upper limit), D Dimer (> 2 × upper limit), age, gender, chronic diseases and CCI scores were compared between the two groups.Results: 68 patients died and 443 patients survived. Mean age was 74.3± 7.3 years in survival group and 76.7± 8.0 in nonsurvival group. Age, male sex, ischemic heart disease (CHD), chronic kidney disease and active malignancy was statistically higher in non-survivor group. The biochemical parameters was compared in survival and nonsurvival group. CCI score, AST, LDH, CK, Ferritin, CRP are significantly higher and albumin, lymphocyte levels are significantly lower in nonsurvival group. D-dimer and procalcitonin levels are significantly higher in nonsurvival group. CCI score and neutrophil, creatinine, ALT, AST, d-dimer and procalcitonin elevations were correlated. Low albumin and lymphocyte levels were correlated with the CCI score. There was no significant correlation between ferritin, sedimentation, CRP levels and CCI score. A multivariate logistic regression analysis indicated that anaemia, elevated CRP (> 10– 20 × upper limit), procalcitonin (> 5– 10 × upper limit), ALT, AST levels and higher CCI score were independent risk factors for mortality in COVID-19 patients.Conclusion: Anaemia, elevated CRP, procalcitonin levels, ALT, AST levels and higher CCI score were found independent risk factors for mortality in COVID-19 patients.Keywords: CCI score, laboratory parameters, mortality, COVID 1