Clinical and laboratory markers of the new coronavirus disease SARS-CoV-2 COVID-19 in hospitalized patients

The prognostic predictors of an unfavorable course of coronavirus disease (COVID-19) and its complications with manifestations of pneumonia and the need for oxygen support and connection to the invasive mechanical ventilation were studied. Clinical and laboratory associations in hospitalized patients with COVID-19 were evaluated, the possible predictors of connection to the invasive mechanical ventilator in 37 patients were identified. Patients were hospitalized on day 6.65±3.32 of the disease, blood oxygen saturation (SpO2) depended on the severity of the disease and response to therapy. Positive significant correlations between the level of growth stimulating factor (ST2) and D-Dimer, creatine phosphokinase MB fraction (CPK-MB) and D-dimmer, CPK-MB and ST2 were revealed, as well as of ferritin and D-Dimer with ST2. There were no significant associations with troponin. C-reactive protein (CRP) probably correlated with CPK-MB and ferritin. The International Normalized Ratio (INR) indicator had significant correlations with D-dimmer, ST2 and CPK-MB. Cox regression analysis showed that the survival curve has a stepwised nature and the highest risk of deterioration, which requires mechanical ventilation, was noted on the 6th day of illness (95.0% CI = 0.9-1.0, with an average SpO2 level =87.3%). ROC analysis showed the presence of a possible relationship between D-Dimer, ST2 protein, CPK-MB and the risk of developing a critical condition requiring mechanical ventilation in patients. The study showed that COVID-19 disease has a phase nature, when after the first phase of the disease, the pulmonary phase and hypercytokinemia progress in some patients with the development of hypoxia, a decrease in SpO2. Therefore, the identification of markers of disease progression is essential for predicting the course and possible prevention of the development of acute respiratory distress syndrome with the use of invasive mechanical ventilation.