Common laboratory tests as indicators of COVID-19 severity on admission at high altitude: a single-center retrospective study in Quito (ECUADOR)

Abstract

The current outbreak of SARS-Cov-2, a virus responsible for the coronavirus disease (namely COVID-19) in Wuhan (CHINA), has infected 107.1 million and caused over 2.34 million deaths worldwide (https://www.worldometers.info/coronavirus/). The main symptoms after infection are fever, dry cough, and fatigue, although disease severity can increase thereafter showing strong inter-individual differences. At worst, severe cases (4.7–6.1%) quickly progress to an acute respiratory distress syndrome (ARDS), septic shock, difficult-to-correct metabolic acidosis, coagulation dysfunction, and multiple organ failure. The fatality rate indeed reaches a 61.5% of the critically ill patients. In the fight against the coronavirus pandemic, prediction of disease severity is an urgent clinical need. COVID-19 prognosis largely relies on the clinical symptoms and computed tomography exams. In the hope to help risk-stratification and guide the timing of admission, some studies have also reported laboratory fluctuations in routine blood tests, which could become the mainstay for the forecasting of COVID-19 patients and the lessening of mortality [1]. Nevertheless, the characterization of the hematological and biochemical findings predicting COVID-19 severity are preliminary due to the low sample sizes, different proportions of severe patients, and geographic selection bias, and should therefore be taken with caution. Hematological biomarkers of COVID-19 severity requires validation by using larger samples of patients from different geographic localizations and ethnic groups across the globe.