Biochemical laboratory findings in adult patients with coronavirus disease 2019 (COVID-19) at a university hospital in Cape Town, South Africa

Keywords: biochemistry tests, cytokine storm, mortality, severity, inflammation

Abstract

Background: The first local cases of coronavirus disease 2019 (COVID-19) were identified in South Africa on 6 March 2020. By July 2020, over 3 500 people had tested positive for SARS-CoV-2 at our hospital, with many admissions to general wards and intensive care units (ICUs). Several biomarkers have been found to be associated with COVID-19 severity and mortality. This study aimed to define abnormal chemistry biomarkers at diagnosis and determine the correlation between these and disease severity and outcome.

Methods: This was a cross-sectional study to investigate the biochemical changes in patients with COVID-19 at our hospital. Clinical and laboratory information of patients with confirmed COVID-19 during the first wave was collected. Cases included patients who had been discharged and those admitted either to a general ward or an ICU between 6 March and 31 July 2020.

Results: A total of 707 adult cases were included. The median age (interquartile range) of patients with mild disease not requiring admission was 43 years (33–56). Patients with moderate disease requiring admission to a general ward had a median age of 50 years (40–60) while those with severe disease had a median age of 52 years (43–60) (p = 0.008). Biochemical parameters positively correlated with disease severity were lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NTproBNP) and alanine aminotransferase (ALT) (p < 0.001, p < 0.001, p = 0.010, p = 0.018 and p = 0.010) respectively). Ferritin was higher in patients with severe disease with marginal statistical significance (p = 0.055).

Conclusion: Our study suggests that age, LDH, CRP, PCT, NTproBNP and ALT levels can be used as predictors of the severity of COVID-19.

Author Biographies

T Jalavu, Stellenbosch University

Division of Chemical Pathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

Z Chapanduka, Stellenbosch University

Division of Haematopathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

I Abdullah, Stellenbosch University

Division of Haematopathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

H Cornelissen, Stellenbosch University

Division of Haematopathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

E Musekwa, Stellenbosch University

Division of Haematopathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

N Mashigo, Stellenbosch University

Division of Haematopathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

C Chetty, Stellenbosch University

Division of Haematopathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

A Zemlin, Stellenbosch University

Division of Chemical Pathology, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, South Africa

Published
2022-06-02