New coronavirus disease (COVID-19): symptoms, laboratory blood indicators in the critically ill and dead patients

Authors

  • V.I. Trykhlib Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • A.P. Kazmirchuk National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • V.V. Grushkevych National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • T.V. Burakova National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.17.4.2021.237722

Keywords:

new coronavirus infection, symptoms, laboratory parameters

Abstract

The article states that the new coronavirus disease (COVID-19) is characterized by a range of clinical manifestations, the development of various complications, inconsistency of clinical, laboratory and instrumental data of the patient’s state, which the authors have observed so far according to the results of our previous studies. A review of the literature is presented on the symptoms, laboratory blood tests of critically ill patients who recovered and those who died of a new COVID-19. Among the hospitalized seriously ill patients, there were mostly men, a signifi­cant number had comorbidities. According to the literature, hospitali­zed critically ill patients with confirmed new COVID-19 in most cases had cough, fever, chills, shortness of breath, lymphopenia. Other symptoms include sputum, headache, dizziness, rhinorrhea, anosmia, dysgeusia, sore throat, abdominal pain, ano­rexia and vomiting, diarrhea, nausea, and muscle pain. The study concluded that doctors, especially after 3 days of illness, when assessing the state of the patient, should pay attention to the following data or their severity, a combination of several symptoms that may suggest the need for hospitalization, particularly in the intensive care unit: the age of the patient; the pre­sence of concomitant pathology (cardiovascular, cerebral, chronic respiratory diseases, diabetes, obesity), especially in the stage of decompensation; the presence and extent of impaired consciousness (Glasgow Coma Scale); cyanosis, pallor of the skin, mucous membranes; acrocyanosis or central cyanosis; duration of fever (> 38 °C) more than 3 days, especially > 39 °C; manifestations of dyspnea (chest tightness, shortness of breath or tachypnea, shortness of breath during exercises), respiratory rate > 24 beats per minute or < 10; heart rate ≥ 125 beats per minute (measured when the patient is sitting); systolic blood pressure < 100 mmHg; SOFA score > 2; CURB-65 score > 2; the presence of signs of emergencies (acute respiratory distress syndrome, acute renal failure, bleedings and others); SpO2 < 93 %; leukocytosis > 10 • 109/l, lymphopenia, thrombocytopenia, serum C-reactive protein > 10 mg/l; an increase in prothrombin time (> 16), in the levels of D-dimer (> 1.5 ng/ml), ferritin (> 300), lactate dehydrogenase (above 360 U/l), procalcitonin (≥ 0.5 ng/ml), lactate (> 2 mmol/L), NT-proBNP (≥ 400 pg/ml), high-sensitivity cardiac troponin (> 5 pg/ml), changes on the electrocardiogram; lung damage more than 25 % according to computed tomography.

References

Overview of COVID-19: Epidemiology, Clinical Presentation, and Transmission. Last Updated: July 17. 2020. Режим доступу: https://www.covid19treatmentguidelines.nih.gov/overview/

Временные методические рекомендации профилактики, диагностики и лечения новой коронавирусной инфекции (COVID-19) / Версия 9 (26.10.2020). Режим доступу: https://sta­tic-0.minzdrav.gov.ru/system/attachments/attaches/000/052/548/original/ %D0 %9C %D0 %A0_COVID-19_ %28v.9 %29.pdf

Clinical Characteristics of Covid-19 in New York City. Режим доступу: https://www.nejm.org/doi/full/10.1056/NEJMc2010419

Fei Zhou, Ting Yu, Ronghui Du et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 28 March — 3 April 2020. Vol. 395. Is. 10229. P. 1054-1062. Режим доступу: https://www.sciencedirect.com/science/article/pii/S0140673620305663

Xiaobo Yang, Yuan Yu, Jiqian Xu, Huaqing Shu et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir. Med. 2020 May. 8(5). 475-481. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102538/

Tao Chen, Di Wu, Huilong Chen et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020. 368: m1091. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190011/

Jamie J. Coleman, Kaveh Manavi, Ella J. Marson et al. COVID-19: to be or not to be; that is the diagnostic question. Postgrad. Med. J. 2020 Jul. 96(1137). 392-398. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306267/

Shadman Aziz, Yaseen M. Arabi, Waleed Alhazzani et al. Managing ICU surge during the COVID-19 crisis: rapid guidelines. Intensive Care Med. 2020 Jun 8. 1-23. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276667

Matthew J. Cummings, Matthew R. Baldwin, Darryl Abrams et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 6–12 June 2020. Vol. 395. Is. 10239. P. 1763-1770; 6–12 June 2020. P. 1763-1770. Режим доступу: https://www.sciencedirect.com/science/article/pii/S0140673620311892

Geehan Suleyman, Raef A. Fadel, Kelly M. Malette et al. Clinical Characteristics and Morbidity Associated with Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit. JAMA Netw Open. Jun 1 2020. 3(6). e2012270. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/32543702

Published

2021-08-18

Issue

Section

Scientific Review