Clinical features and biochemical parameters influencing mortality in COVID-19 patients -- Retrospective study from Telangana, India.

The coronavirus disease COVID-19 caused by SARS-CoV-2 was a worldwide public health emergency which affected millions of people including frontline healthcare workers too. We evaluated the clinical features and biochemical investigations in COVID-19 affected healthcare workers (HCW) admitted to NIMS Intensive care unit (ICU) including survivors and non-survivors to identify risk factors for mortality. We did a retrospective study of 78 HCW with RTPCR confirmed COVID-19 infection admitted in ICU between July and November, 2020. Subjects were grouped into survivors and non-survivors. Clinical features and biochemical investigations were compared. Survival analysis was performed to analyze the risk factors of mortality. Out of the 78 patients admitted to ICU, the majority were males (64%). Non-survivor patients were older with a median age of 64 years. There were significantly higher proportion of females (59%) in non-survivors. COVID-19 non-survivors had significantly more incidence of cardiovascular disease and also higher blood levels of AST, CPK, CRP, D-dimer, IL-6, LDH, urea, NTproBNP and procalcitonin. Hazard's ratios showed that the mortality risk was significantly higher and survival was significantly lower in patients more than 60 years in age, females and those having IL-6 >40.06 pg/mL, LDH >461U/L, NTproBNP >1188 pg/mL, procalcitonin >0.5 pg/mL, urea >67 mg/dL, creatinine >1.3 mg/dL, D-dimer >573 ng/mL, ferritin >1488 ng/mL, andCPK >191U/L. Our study identified that the mortality risk was significantly higher and survival was significantly lower in patients older age group, females and those having higher IL-6, LDH, NTproBNP, procalcitonin, urea, creatinine, D-dimer, ferritin and CPK. Determination of specific clinical and biochemical features as above would help in better understanding of the pathophysiology, prognosis and appropriate intervention for potential outcomes. [ABSTRACT FROM AUTHOR]