Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2022; 10(23): 8161-8169
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8161
Comparison of demographic features and laboratory parameters between COVID-19 deceased patients and surviving severe and critically ill cases
Lei Wang, Yang Gao, Zhao-Jin Zhang, Chang-Kun Pan, Ying Wang, Yu-Cheng Zhu, Yan-Peng Qi, Feng-Jie Xie, Xue Du, Na-Na Li, Peng-Fei Chen, Chuang-Shi Yue, Ji-Han Wu, Xin-Tong Wang, Yu-Jia Tang, Qi-Qi Lai, Kai Kang
Lei Wang, Xue Du, Na-Na Li, Peng-Fei Chen, Chuang-Shi Yue, Ji-Han Wu, Xin-Tong Wang, Yu-Jia Tang, Qi-Qi Lai, Kai Kang, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Yang Gao, Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Harbin 150028, Heilongjiang Province, China
Zhao-Jin Zhang, Department of Critical Care Medicine, The Yichun Forestry Administration Central Hospital, Yichun 153000, Heilongjiang Province, China
Chang-Kun Pan, Department of Critical Care Medicine, The Jiamusi Cancer Hospital, Jiamusi 154007, Heilongjiang Province, China
Ying Wang, Department of Critical Care Medicine, The First People Hospital of Mudanjiang City, Mudanjiang 157011, Heilongjiang Province, China
Yu-Cheng Zhu, Department of Critical Care Medicine, The Hongxinglong Hospital of Beidahuang Group, Shuangyashan 155811, Heilongjiang Province, China
Yan-Peng Qi, Department of Cardiology, The Hongxinglong Hospital of Beidahuang Group, Shuangyashan 155811, Heilongjiang Province, China
Feng-Jie Xie, Department of Critical Care Medicine, The Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang 157011, Heilongjiang Province, China
Author contributions: Wang L, Gao Y, and Kang K took part in the conception, literature search, study design, statistical analysis, analysis and discussion of results, and manuscript preparation, editing, and review; Zhang ZJ, Pan CK, Wang Y, Zhu YC, Qi YP, Xie FJ, Du X, Li NN, Chen PF, Yue CS, Wu JH, Wang XT, Tang YJ, and Lai QQ provided assistance for the conception, literature search, data acquisition and collation, statistical analysis, analysis and discussion of results, and manuscript preparation; Wang L and Gao Y contributed equally to this work; all authors read and approve the final manuscript.
Supported by National Natural Science Foundation of China, No. 81902000.
Institutional review board statement: This study was approved by the Ethics Committee of The First Affiliated Hospital of Harbin Medical University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Kang, MMed, Chief Doctor, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 Post Street, Harbin 150001, Heilongjiang Province, China. janekk79@126.com
Received: April 6, 2022
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
Processing time: 116 Days and 22.3 Hours
Abstract
BACKGROUND

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.

AIM

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

Keywords: COVID-19; SARS-CoV-2; Deceased patients; C-reactive protein; D-dimer; Neutrophil percentage; Lymphocyte count; Platelet

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.