Correlation analysis between COVID-19 disease severity and clinical and biochemical parameters in a rural tertiary care hospital of central Maharashtra, India

BACKGROUND: The novel coronavirus (COVID-19) infection continues to wreak havoc across the developed world and now seems to have gained a strong foothold in developing countries including India. The mortality rate in severe/critically ill patients with COVID-19 is high. The present study was conducted to analyze the clinical and laboratory markers that discriminate severe/critically ill patients from those with mild/moderate COVID infection early for better clinical management of the disease. METHODS: This laboratory-based, cross-sectional study was conducted on 517 confirmed cases of COVID-19 disease. The patients were divided into mild/moderate and severe/critical groups. Correlation analysis between COVID-19 disease severity and clinical and biochemical parameters was performed on the confirmed COVID-19 infection patients admitted to Shri Vasantrao Naik Government Medical College, Yavatmal, from March 15, 2020, to July 20, 2020. The Pearson correlation coefficient was used for the variables with normal distribution. Cut-off values for critically ill patients were speculated through the receiver-operating characteristics (ROC) curve. RESULTS: The study population included 517 confirmed cases of COVID-19 infection. The median age of the patients was 34 years (IQR: 22–47; range: 18-64 years), with a male to female ratio of 1.2:1. Moreover, 176 (34.04%) patients had one or more co-morbidities, and hypertension (11.5%) and diabetes mellitus (DM‎) (10.44%) were the most common coexisting co-morbidities. A significant difference was observed between the mild/moderate group and severe/critically ill patients group in the laboratory parameters of serum ferritin, D-dimer, CRP, LDH, prolactin, albumin, ionic calcium, cTnI, and IL6. CONCLUSION: Clinicians should consider age, co-morbidities, and laboratory parameters like lymphopenia, elevated D-dimer levels, elevated CRP, IL6, serum ferritin, cTnI, and