Clinical characteristics of COVID-19 patients in Latvia under low incidence in Spring 2020

  1. Ludmila Viksna
  2. Oksana Kolesova
  3. Aleksandrs Kolesovs
  4. Ieva Vanaga
  5. Seda Arutjunana
  6. Sniedze Laivacuma
  7. Jelena Storozenko
  8. Ieva Tolmane
  9. Ilze Berzina
  10. Baiba Rozentale

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Abstract

Background

COVID-19 is a new infectious disease with severe disease course and high mortality in some groups. Blood tests on admission to the hospital can be useful for stratification of patients and timely correction. Our study investigated the clinical features of COVID-19 patients in Latvia and differences in blood tests in groups with different disease severity.

Methods

The retrospective study included 100 patients hospitalized in Riga East Clinical University Hospital in Spring 2020. The severity of the disease course was classified by the presence of pneumonia and its combination with respiratory failure. We have assessed blood cells’ count, hemoglobin, hematocrit, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), alanine aminotransferase, lactate dehydrogenase (LDH), troponin T, electrolytes, creatinine, glomerular filtration rate (GFR), D-dimer, prothrombin time, prothrombin index, oxygen saturation, and temperature on admission to the hospital.

Results

Patients were from 18 to 99 (57±18 years, 57% males). Comorbidities were found in 74% of patients. The mild, moderate, and severe groups included 35, 44, and 16 patients, respectively. In the severe group, the mortality rate was 50%. The progression to severe COVID-19 was associated positively with temperature, ESR, CRP, creatinine, LDH, and troponin T and negatively associated with oxygen saturation, eosinophils, and GFR on admission to the hospital.

Conclusions

COVID-19 severity associates with lower renal function and a higher level of inflammation and tissue damage. Eosinophils, CRP, ESR, LDH, troponin T, creatinine, and GFR are blood indicators for monitoring patients’ condition.

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  1. ScreenIT

    SciScore for 10.1101/2020.12.22.20239392: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The Permission of the Central Medical Ethics Committee (protocol No. 01-29.1/2429) and Permission of the Ethics Committee of Riga Stradinš University (protocol No. 6-1/07/14) were obtained for this study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    We have used IBM SPSS 22.0 for computations.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    A relatively low number of patients in Spring 2020 was a positive trend and, simultaneously, a limitation of our study. There was a limited opportunity to predict disease severity or death because some measures were performed on a limited number of patients. Taking into account these shortcomings, we have started a prospective study in September 2020. In conclusions, the most unexpected discrepancy with other studies was observed in the rate of gastrointestinal symptoms and self-reported loss of smell or taste on admission to the hospital. A limited number of patients reported them in our sample. The low eosinophil count was also pronounced in our patients with severe disease course, while other studies revealed a low lymphocyte count under severe COVID-19. The progression to severe COVID-19 was associated positively with ESR, CRP, creatinine level, LDH, troponin T and negatively associated with blood oxygen saturation, eosinophils, and GFR on admission to the hospital. Therefore, patients with severe COVID-19 demonstrated lower renal function and a higher level of inflammation and tissue damage than those with a milder disease course. These indicators can be applied in the clinical assessment and monitoring of patients. Further research in Latvian patients can be useful for the specification of significant trends and correction of clinical guidelines.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.12.22.20239392v1 on medRxiv