Clinical and laboratory manifestations in critically ill patients with COVID-19 and deceased people

Authors

  • V.I. Trykhlib Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • T.I. Lysenko Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • A.O. Yeroshenko Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • О.S. Martynchyk Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • K.P. Bieliaieva Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • N.R. Tsiurak Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • S.O. Nevmerzhytsky Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • V.V. Hrushkevych National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • O.I. Samoilenko National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • O.V. Kulova National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • Yu.I. Danylenko National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • V.I.  Lysko National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • Yu.O. Boklan 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
  • I.V. Chub National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • O.Kh. Nasibullin National Military Medical Clinical Center “Main Military Clinical Hospital”, Kyiv, Ukraine, Ukraine
  • T.I. Shevelova Central Hospital of the Ministry of Internal Affairs of Ukraine, Kyiv, Ukraine, Ukraine
  • S.S. Popova Central Hospital of the Ministry of Internal Affairs of Ukraine, Kyiv, Ukraine, Ukraine
  • S.M. Samoilova Central Hospital of the Ministry of Internal Affairs of Ukraine, Kyiv, Ukraine, Ukraine
  • S.M. Chaika Central Hospital of the Ministry of Internal Affairs of Ukraine, Kyiv, Ukraine, Ukraine
  • O.S. Holubenko Central Hospital of the Ministry of Internal Affairs of Ukraine, Kyiv, Ukraine, Ukraine
  • А.V. Moroz Central Polyclinic of the Ministry of Internal Affairs of Ukraine, Kyiv, Ukraine, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.17.4.2021.237727

Keywords:

new coronavirus infection, symptoms, laboratory parameters

Abstract

This article provides a review of the literature on the symptoms, laboratory blood values of critically ill patients who recovered and those who died of the new coronavirus disease COVID-19. Physicians should consider the following when predicting the course of the disease: in the first 3 days after admission, patients who recovered were slightly more likely to have leukocytosis and leukopenia, normal and increased lymphocyte counts; there were more individuals with increased number of band neutrophils, and patients who subsequently died were more likely to have normocytosis, granulocytosis, lymphopenia, thrombocytopenia, and higher erythrocyte sedimentation rate. The evaluation of laboratory indices in dynamics is of great importance for the prognosis: patients who recovered, on day 4–6 had a less pronounced growth of leukocytes and subsequently, on the contrary, their reduction; on day 4–6 of hospital stay, there was a decrease in the number of lymphocytes with subsequent growth; high creatine phosphokinase values at the beginning of hospitalization decreased significantly from day 7–9 to reference values; from the time of hospitalization, there was a decrease in lactate dehydrogenase content; the average prothrombin index tended to decrease, but within normal limits. Patients who died later, already from day 4–6 had an increase in leukocyte count, a decrease in lymphocyte level; thrombocytopenia was registered more often, which persisted with time and decreased significantly, especially after 9 days; in all periods of observation, erythrocyte sedimentation rate was higher (median of 30–40 mm/h); from day 7, there were significant fluctuations in maximum creatine phosphokinase values with their significant increase; at the beginning of hospitalization, these patients had higher lactate dehydrogenase levels compared to the first group and maintained their advantages during all periods of observation with significant fluctuations of maximal values; when comparing these patients by observation periods, there were slight fluctuations in the prothrombin index, which most often registered in about 80 % of patients with a subsequent increase after day 9, but within normal limits; also, at the beginning of hospitalization, there were significant fluctuations in the minimum prothrombin index towards very low rates.

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Published

2021-08-18

Issue

Section

Original Researches