Association between Laboratory Findings and Mortality of Hospitalized Patients with Covid-19 in Mashhad, Iran

Abstract Background and Objective: COVID-19 has enforced high burden on health systems universally. To better allocate limited health equipment, we aimed to investigate the prognostic impacts of laboratory parameters. Materials and Methods: All SARS-CoV-2 patients admitted to Imam-Reza University Hospital, Mashhad, Iran, during three COVID19 peak periods in Iran (March to April 2020, July to August, and October to November 2020) were enrolled the study. Demographic and laboratory data were extracted and compared between survivors and non-survivors. Regression analyses and receiver operating characteristic (ROC curve) were used to identify risk factors and assess the ability of laboratory tests in predicting in-hospital mortality. Results: A total of 2156 COVID19 patients were included in the analysis, with a mean age of 60.20 (±18.8) years. Most patients were male (57%). Multiple regression analysis identified older age (OR=1.01), male sex (OR=2.34), lymphopenia (OR=2.12), LDH >500U/L (OR=2.17), hypernatremia (OR=9.7), urea >45mg/dL (OR=3.6), and BS >200mg/dl (OR=1.93) as significant risk factors for in-hospital death. Using ROC curve analysis, D-dimer (>1000ng/ml) as well as CK-Mb (>28U/L) both with sensitivities and specificities of more than 80% and PPV of about 90% were able to identify patients with higher possibility of in-hospital death. Conclusion: Male sex, older age, lymphopenia, hypernatremia, increased Urea, increased LDH, and hyperglycemia may serve as potential risk factors for in-hospital death. D-dimer and CK-MB may be used in identifying patients with high probability of in-hospital death. These tests may be used in clinical decision-making in order to improve outcomes of patients with COVID-19. Keywords: COVID-19, Laboratory tests, Mortality, Prognosis, Risk factors, SARS-CoV-