Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8161
Peer-review started: April 6, 2022
First decision: May 11, 2022
Revised: May 15, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 16, 2022
Coronavirus disease 2019 (COVID-19) has been far more devastating than expected, showing no signs of slowing down at present. Heilongjiang Province is the most northeastern province of China, and has cold weather for nearly half a year and an annual temperature difference of more than 60ºC, which increases the underlying morbidity associated with pulmonary diseases, and thus leads to lung dysfunction. The demographic features and laboratory parameters of COVID-19 deceased patients in Heilongjiang Province, China with such climatic characteristics are still not clearly illustrated.
To illustrate the demographic features and laboratory parameters of COVID-19 deceased patients in Heilongjiang Province by comparing with those of surviving severe and critically ill cases.
COVID-19 deceased patients from different hospitals in Heilongjiang Province were included in this retrospective study and compared their characteristics with those of surviving severe and critically ill cases in the COVID-19 treatment center of the First Affiliated Hospital of Harbin Medical University. The surviving patients were divided into severe group and critically ill group according to the Diagnosis and Treatment of New Coronavirus Pneumonia (the seventh edition). Demographic data were collected and recorded upon admission. Laboratory parameters were obtained from the medical records, and then compared among the groups.
Twelve COVID-19 deceased patients, 27 severe cases and 26 critically ill cases were enrolled in this retrospective study. No differences in age, gender, and number of comorbidities between groups were found. Neutrophil percentage (NEUT%), platelet (PLT), C-reactive protein (CRP), creatine kinase isoenzyme (CK-MB), serum troponin I (TNI) and brain natriuretic peptides (BNP) showed significant differences among the groups (P = 0.020, P = 0.001, P < 0.001, P = 0.001, P < 0.001, P < 0.001, respectively). The increase of CRP, D-dimer and NEUT% levels, as well as the decrease of lymphocyte count (LYMPH) and PLT counts, showed significant correlation with death of COVID-19 patients (P = 0.023, P = 0.008, P = 0.045, P = 0.020, P = 0.015, respectively).
Compared with surviving severe and critically ill cases, no special demographic features of COVID-19 deceased patients were observed, while some laboratory parameters including NEUT%, PLT, CRP, CK-MB, TNI and BNP showed significant differences. COVID-19 deceased patients had higher CRP, D-dimer and NEUT% levels and lower LYMPH and PLT counts.
Core Tip: Early detection and intervention of coronavirus disease 2019 (COVID-19) patients with a higher risk of death will contribute to rationally allocate limited medical resources and reduce the case-fatality rate. Our results illustrated that some laboratory parameters, including neutrophil percentage (NEUT%), platelet (PLT), C-reactive protein (CRP), creatine kinase isoenzyme, serum troponin I and brain natriuretic peptides showed significant differences in COVID-19 deceased patients compared with surviving severe and critically ill cases. COVID-19 deceased patients had higher CRP, D-dimer and NEUT% levels and lower lymphocyte count and PLT counts. Our study added evidence to the notion that the pathogenesis of COVID-19 deceased patients was related to the superimposed bacterial or fungal infection, cellular immune deficiency, coagulation disorder, activation of inflammatory cytokine responses, and impaired organ function, which in turn could interact with each other, forming a complicated network.