• Sehveta Mustafić, Edin Jusufović, Fatima Hukić, Emir Trnačević, Anja Divković, and Alma Trnačević.
• Department of Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.
• Med Glas (Zenica). 2021 Aug 1; 18 (2): 384-393.

AbstractAim To identify laboratory tests for early detection and the development of more severe illness and death in COVID-19 hospitalized patients. Methods A prospective study was done on 66 hospitalized COVID-19 patients (males: 54.5%; mean age 70.1 ± 9.6 years) who were stratified into: moderate (n=36; 54.5%), severe (n=12; 18.2%), and critically ill (n=18; 27.3%). Besides clinical findings, a wide spectrum of laboratory parameters was monitored at admission and control during the first seven days of hospitalization and used to predict progression from non-severe to severe illness and to predict the final outcome. Results Critically ill patients showed a higher control value of white blood cell count, C-reactive protein, lactate dehydrogenase, ferritin, but lower lymphocyte count and O2 saturation. Patients with fatal outcome (23; 34.85%) showed a higher control value of neutrophil, lactate dehydrogenase, ferritin, and lower lymphocyte and O2 saturation. Progression from moderate to severe or critical illness was predicted by increasing lactate dehydrogenase (95% CI 0.5803 to 0.8397;p=0.003729), increase in ferritin (95% CI 0.5288 to 0.8221;p=0.03248), and by drop in O2 saturation (95% CI 0.5498 to 0.8179;p=0.01168). A fatal outcome was predicted by increase in ferritin (95% CI 0.5059 to 0.8195;p=0.04985), as well as by drop in O2 saturation (95% CI 0.5916 to 0.8803; p=0.001861). Conclusion Increase in ferritin, and drop in O2 saturation could be the most important prognostic parameters for the development of more severe clinical illness and death in COVID-19 hospitalized patients.Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

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