Original Research

Clinical and Biochemical Profile of Patients with COVID - 19 Infection; A Multicenter-Retrospective Study from three Tertiary Care Hospitals of Lahore, Pakistan

DOI https://doi.org/10.70302/jpsim.v2i1.2112
Received: 07 Dec 2020 Accepted: 21 Jan 2021 Published Online: 13 Mar 2021

Abstract

Objectives

To assess the clinical and biochemical profile of patients with Covid – 19 infection in three major
tertiary care hospitals of Lahore, Pakistan.

Methods

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

How to Cite This Article

Iqbal J, Chachar AZK, Chaudhary A, Khan AA, Kazi A, Fatima A, et al.. Clinical and Biochemical Profile of Patients with COVID - 19 Infection; A Multicenter-Retrospective Study from three Tertiary Care Hospitals of Lahore, Pakistan. J Pak Soc Intern Med. 2021;2(1):42–46. doi:10.70302/jpsim.v2i1.2112

⭳ Download PDF

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. 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]
  2. 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.
  3. World Health Organization official Dashboard. [Updated; 2020, Cited 2021]. Available from: [https://covid19.who.int/?gclid=CjwKCAiAjeSABhAPEiwAqfxURetnJGZrInWz2O-KQpKF1KkzH3plXefuXyq4tF1Y8Q8Tqnnp9Nj21RoCgusQAvD_BwE]
  4. Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020; doi: 10.1016/j.clim.2020.108427 doi:10.1016/j.clim.2020.108427
  5. 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;doi: 10.1007/s11684-020-0754-0 doi:10.1007/s11684-020-0754-0
  6. 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.
  7. 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:https://doi.org/10.1016/j.metabol.2020.154262 doi:10.1016/j.metabol.2020.154262
  8. 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
  9. Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID‐19. Lancet Haematol. 2020;7(6):e438‐40.
  10. Chen C, Zhou Y, Wang DW. SARS‐CoV‐2: a potential novel etiology of fulminant myocarditis. Herz. 2020;45(3):230-2.
  11. 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.
  12. 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; doi:10.1017/ice.2020.1297. doi:10.1017/ice.2020.1297
  13. 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; https://doi.org/10.1007/s42399-020-00363-4. doi:10.1007/s42399-020-00363-4
  14. 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; https://doi.org/10.1016/j.eclinm.2020.100570. doi:10.1016/j.eclinm.2020.100570
  15. 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.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2021 Journal of Pakistan Society of Internal Medicine.