JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v2i1.2112 jpsim.v2i1.2112 Original Research Clinical and Biochemical Profile of Patients with COVID - 19 Infection; A Multicenter-Retrospective Study from three Tertiary Care Hospitals of Lahore, Pakistan Iqbal Javeid Chachar Aijaz Zeeshan Khan dr_aijaz84@hotmail.com * Chaudhary Aneela Khan Asma Afzal Kazi Asma Fatima Arzinda Chaudhary Saima Fatima Memorial Hospital, Lahore Services Hospital, Lahore Jinnah Hospital, Lahore Rashid Latif Medical College, Lahore *Correspondence: Aijaz Zeeshan Khan Chachar (dr_aijaz84@hotmail.com) 13 03 2021 2021 2 1 42 46 07 12 2020 21 01 2021 Copyright © 2021 The Author(s) 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives

To assess the clinical and biochemical profile of patients with Covid – 19 infection in three major

tertiary care hospitals of Lahore, Pakistan.

 Methodology

Retrospective observational study involving three tertiary care hospitals of Lahore. Fatima

Memorial Hospital, Services Hospital and Jinnah Hospital, Lahore. Sample Size: Total 100 patients; Study

duration: 2 months, 15th October to 15th December, 2020.

 Results

Atotal of 100 patients hospitalized with Covid-19 infection were observed in this retrospective study.

The commonest symptoms observed were fever, shortness of breath and cough with 80.4%, 63.0% and 57.6%

percentages respectively. Diabetes was the most prevalent pre-existing condition with 29% men and 21%

women known to have the disease. Although, many more male patients required oxygen n= 47 than female

patients n = 26, the p-value wasn't significant (p-value = 1.000). Our observational study also demonstrated

lymphopenia in both gender groups with median lymphocyte count being 14. The total neutrophil count was a

median =77 with IQR = 22.0. The neutrophil-to-lymphocyte ratio was 5.85 (median). We observed higher

levels of inflammatory markers in men as compared to women. Median CRP of 74 versus 27.28 in men and

women respectively. Median serum ferritin of 635.93 in men compared to median of 361.00 in women. Both

values correspond to increased disease severity in men. We observed a total d-dimer median of 1.13 (IQR 3.24)

with no difference between our gender groups (p-value = 0.797). We observed patients Troponin I was

recorded as median of 5.90 in male patients compared with median of 3.60 in female patients. Our cohort of

patients demonstrated a median serum creatinine of 0.99 (IQR = 0.51).

 Conclusion

Patients with multiple co-morbidities and having high Neutrophil to lymphocyte ratio, increased

inflammatory markers and raised markers of organ dysfunction are at increased risk of developing severe

disease with gender variation too as males are more prone to develop severe infection.

 Keywords Covid-19 SARS- CoV Biochemical Profiles Lahore References World Health Organization. GCM teleconference – Note for the Records. Subject: Pneumonia in Wuhan, China [Updated; 2020, Cited 2021]. Available from: [https://www.who.int/blueprint/10‐01‐2020‐nfr‐gcm.pdf?ua=1] Lu R, Zhao X, Li J, Niu P, Yang B, Wu H et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395(10224): 565– 74. World Health Organization official Dashboard. [Updated; 2020, Cited 2021]. Available from: [https://covid19.who.int/?gclid=CjwKCAiAjeSABhAPEiwAqfxURetnJGZrInWz2O-KQpKF1KkzH3plXefuXyq4tF1Y8Q8Tqnnp9Nj21RoCgusQAvD_BwE] Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020; 10.1016/j.clim.2020.108427 Zou X., Chen K., Zou J., Han P., Hao J., Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020;10.1007/s11684-020-0754-0 Feng Wang, Huilan Zhang, Ziyong Sun. The laboratory tests and host immunity of COVID-19 patients with different severity of illness; J CI Insight. 2020;5(10):e137799. Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020; doi:10.1016/j.metabol.2020.154262 Huang W, Berube J, McNamara M, Saksena S, Hartman M, Arshad T et al. Lymphocyte subset counts in COVID‐19 patients: a meta‐analysis. Cytometry A. 2020; 97(8):772-6 Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID‐19. Lancet Haematol. 2020;7(6):e438‐40. Chen C, Zhou Y, Wang DW. SARS‐CoV‐2: a potential novel etiology of fulminant myocarditis. Herz. 2020;45(3):230-2. Bonetti G, Manelli F, Patroni A, Bettinardi A, Borrelli G, Fiordalisi G, et al. Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy. Clin Chemistry Lab Med. 2020;58(7):1100-5. Malenfant JH, Newhouse CN, Kuo AA. Frequency of coronavirus disease 2019 (COVID-19) symptoms in healthcare workers in a large health system. Infection Control & Hospital Epidemiology. 2020; 10.1017/ice.2020.1297. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, Hosein Z, Padda I, Mangat J, Altaf M. Comorbidity and its Impact on Patients with COVID-19. SN Compr Clin Med. 2020; 10.1007/s42399-020-00363-4. Calligaro GL, Lalla U, Audley G, Gina P, Miller MG, Mendelson M, et al. The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study. E Clin Med. 2020; 10.1016/j.eclinm.2020.100570. Liao D, Zhou F, Luo L, Xu M, Wang H, Xia J, et.al. Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study. Lancet Haematol. 2020;7(9):e671-8.