Evaluation of the effects of ferritin, LDH, lymphopenia and D-dimer levels on prognosis and mortality in patients with COVID-19

Aim: COVID-19 is a viral disease with a poor prognosis that may result in respiratory distress and death if it's clinical course is not foreseen and intervened in a timely manner. In hospitalized patients with COVID-19, laboratory biomarkers are needed that allow early risk assesment before obvious signs of clinical deterioration appear. This study aimed to evaluate the relationship between ferritin, LDH, lymphopenia, D-Dimer levels and the prognosis and mortality of COVID-19. Material and Method: Our study included 351 patients with a diagnosis of COVID-19 who were hospitalized in the pandemic service between 18 March 2020 and 1 November 2020 whose nasopharyngeal swab samples were taken and the RT-PCR test was positive. Our study included 65 patients who were died as the case group and 286 patients who were recovered as the control group. The laboratory data (ferritin, LDH, lymphopenia, D-Dimer) of the patients were evaluated from the first blood tests (pre) taken from the first moment of admission to the hospital and the blood tests taken from before the patient's discharge or exitus (post) were evaluated retrospectively. The compilation of the data within the research was obtained through the Hospital Information Management System (HIMS). The results were analyzed with the Statistical Package for the Social Sciences (SPSS) 21.0. Results: Of the 351 patients included in the study, 184 (%52,4) were male and 167 (%47,6) were female; mean age was 61,9 ± 17,1 years. Age and length of hospital stay of the patients were found to be significantly higher in the deceased group. As a result of the statistical analysis, D-Dimer pre (p:0,002) and post (p:0,001), ferritin pre and post (p:0,001), LDH pre and post (p:0,001) values were significantly higher in the deceased group than in the recovered group. On the other hand, the medians of lymphocyte pre and post (p:0,001) were found to be significantly higher than the medians of the people in deceased group. Conclusions: According to the results of our study, high levels of ferritin, D-Dimer and LDH from the onset of the disease and the absence of an increase in lymphocyte levels indicate that it may be a stimulus for mortality. As a result, ferritin, LDH, D-Dimer elevation and lymphopenia are important and reliable indicators in planning the appropriate treatment in time and determining prognosis and mortality in COVID-19 patients. Keywords: COVID-19, ferritin, LDH, lymphopenia, D-Dimer