Characteristics, Outcomes and Indicators of Severity for COVID-19 Among Sample of ESNA Quarantine Hospital’s Patients, Egypt: A Retrospective Study

Ali A Ghweil,¹ Mohammed H Hassan,² Ashraf Khodeary,³ Ahmed Okasha Mohamed,⁴ Haggagy Mansour Mohammed,⁵ Ahmed Alyan Abdelazez,¹ Heba Ahmed Osman,¹ Shamardan Ezzeldin S Bazeed<sup>1

1</sup>Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, Qena 83523, Egypt; ²Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena 83523, Egypt; ³Clinical Pathology Department, Faculty of Medicine, Sohag University, Sohag 82519, Egypt; ⁴Department of Radiology, Faculty of Medicine, South Valley University, Qena 83523, Egypt; ⁵Department of Chest Diseases, Faculty of Medicine, South Valley University, Qena 83523, Egypt

Correspondence: Mohammed H Hassan
Medical Biochemistry Department, Faculty of Medicine, South Valley University, Qena, Egypt
Tel +201098473605
Email Mohammedhosnyhassaan@yahoo.com

Background: The risk factors, disease characteristics, severity, and mortality of COVID-19 are unclear, particularly in Egypt.
Objective: The objective was to analyze the patients’ characteristics, hematological, biochemical, and chest imaging findings among the cohort of patients with COVID-19 in Egypt and also to shed light on the predictors of COVID-19 severity.
Patients and Methods: A retrospective study was conducted on 66 patients with COVID-19 in Egypt. Medical history, imaging data (CT chest findings), and measured hematological and biochemical parameters at diagnosis were recorded in the form of complete blood counts and differential counts; CRP, ESR, serum ferritin, creatinine, and liver function tests . Results of real-time reverse transcription-polymerase chain reaction (rRT-PCR) for detection of SARS-CoV-2 RNA at diagnosis and during follow up of these patients were also recorded.
Results: The study included 36 patients with mild to moderate COVID-19 and 30 patients with severe/critical infection. There was a significant older age among severe (62.6 years old ± 10.1SD) than mild to moderate infection (55.5 ± 10.1) (p˂0.05). Fever, dry cough, dyspnea, and sore throat malaise were highly frequent among COVID-19 patients, while headache and diarrhea were the least frequently occurring manifestations. All included cases (30 patients, 100%) with severe COVID-19 showed crazy-paving appearance (in the form of reticular and/or interlobular septal thickening) with or without GGO. There were significantly lower mean values of WBCs, lymphocytic count, total protein, and albumin among the severely infected than those who had mild to moderate COVID-19 infection, p˂0.05 for all. Additionally, there were significantly higher mean values of CRP, ESR, ferritin, ALT, and AST among patients with severe/critical COVID-19 when compared with those having mild to moderate COVID-19, p˂0.05 for all.
Conclusion: Among the studied demographic, clinical, hematological, biochemical, and imaging data, dyspnea, diabetes mellitus, lymphopenia, raised CRP, ESR, ferritin, ALT, AST, low albumin, and presence of CT chest findings could be considered as predictors for COVID-19 severity using binary logistic regression analysis.

Keywords: COVID-19, Egypt, clinical data, hematological parameters, SARS-CoV-2 RNA, biochemical markers, severity