Manuel Crespo Hernández, Esther Vergara, Marta Navas-Parejo Alonso, Sergio Burillo-Sanz, Francisco M. Marco, Cristina Abad-Molina, Paula Álvarez, Ricardo Rojo, Vanesa Cunill, Jesús Ontañón, Javier Muñoz-Vico, Mercedes Martín, Bibiana Quirant, Oana Irina Sobieschi, Oscar Yarce, Marta Aguilar, Ana Navas, Yesenia Jiménez-de las Pozas, Juana Gil-Herrera, Serafín López-Palmero, Danilo Escobar, Antonio J. Trujillo, Juan Ramón Molina, Francisco Boix, Josefa Melero, Gonzalo Ocejo-Vinyals, María T. Martínez-Saavedra, Antonio Orduña, Delia Almeida, Beatriz Rodríguez-Bayona, Celia López-Sanz, Eva Martínez-Cáceres, Sergi Cantenys-Molina, Laura Esparcia-Pinedo, Marcos López-Hoyos, Sergio Mora, Marc Boiges, Janire Perurena-Prieto, David San Segundo, Luis Manuel Lozano Fernández, Alba Martínez, David Monzón, Esther Ocaña, Silvia Medina, Aurora Jurado, María C. Vegas-Sánchez, Gema Gonzalez-Martinez, Alvaro Prada, Universidad de Cantabria, Institut Català de la Salut, [Martín MC] Centro de Hemoterapia y Hemodonación de Castilla y León, Valladolid, Spain. [Jurado A, Yarce O, Navas AM] Department of Immunology and Allergology, Hospital Universitario Reina Sofía-Instituto de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain. [Abad-Molina C, Orduña A] Department of Microbiology and Immunology, Hospital Clínico Universitario, Valladolid, Spain. [Hernández M, Perurena-Prieto J] Servei d’Immunologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
Background One hundred fifty million contagions, more than 3 million deaths and little more than 1 year of COVID-19 have changed our lives and our health management systems forever. Ageing is known to be one of the significant determinants for COVID-19 severity. Two main reasons underlie this: immunosenescence and age correlation with main COVID-19 comorbidities such as hypertension or dyslipidaemia. This study has two aims. The first is to obtain cut-off points for laboratory parameters that can help us in clinical decision-making. The second one is to analyse the effect of pandemic lockdown on epidemiological, clinical, and laboratory parameters concerning the severity of the COVID-19. For these purposes, 257 of SARSCoV2 inpatients during pandemic confinement were included in this study. Moreover, 584 case records from a previously analysed series, were compared with the present study data. Results Concerning the characteristics of lockdown series, mild cases accounted for 14.4, 54.1% were moderate and 31.5%, severe. There were 32.5% of home contagions, 26.3% community transmissions, 22.5% nursing home contagions, and 8.8% corresponding to frontline worker contagions regarding epidemiological features. Age > 60 and male sex are hereby confirmed as severity determinants. Equally, higher severity was significantly associated with higher IL6, CRP, ferritin, LDH, and leukocyte counts, and a lower percentage of lymphocyte, CD4 and CD8 count. Comparing this cohort with a previous 584-cases series, mild cases were less than those analysed in the first moment of the pandemic and dyslipidaemia became more frequent than before. IL-6, CRP and LDH values above 69 pg/mL, 97 mg/L and 328 U/L respectively, as well as a CD4 T-cell count below 535 cells/μL, were the best cut-offs predicting severity since these parameters offered reliable areas under the curve. Conclusion Age and sex together with selected laboratory parameters on admission can help us predict COVID-19 severity and, therefore, make clinical and resource management decisions. Demographic features associated with lockdown might affect the homogeneity of the data and the robustness of the results.