COVID-19 infection in a resource-limited setting: Predictors of severity and mortality | ||
Microbes and Infectious Diseases | ||
Article 4, Volume 6, Issue 2, May 2025, Pages 444-454 PDF (388.16 K) | ||
Document Type: Original Article | ||
DOI: 10.21608/mid.2024.332889.2325 | ||
Authors | ||
Ahmed Suliman Yassin1; Ibrahim Abdelrhim Ali1; Muaath Ahmed Mohammed* 1; Izzut Awad Ahmed1; Nisreen DaffaAlla Omer2, 3 | ||
1Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan. | ||
2Basic Medical Department, College of Medicine, Almaarefa University, Riyadh, Saudi Arabia | ||
3Department of Physiology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan. | ||
Abstract | ||
Background: Following the declaration of COVID-19 infection as a pandemic by the World Health Organisation (WHO), researchers have been working to identify diagnostic and prognostic markers while considering the accuracy and cost-effectiveness of the selected method. This study aimed to identify common COVID-19 infection clinical severity and outcome predictors in a resource-constrained setting. Method: This analytical cross-sectional study involved 91 COVID-19 infection patients diagnosed with real-time polymerase chain reaction (RT‒PCR) for SARS-CoV-2. The prognostic usefulness of several COVID-19 infection predictors was assessed using multiple logistic regression analysis and the receiver operating characteristic (ROC) curve. A P value< 0.05 is considered significant. Results: The mean age of the participants was 65.37±12.13 years, with males being predominant 51(56%). Furthermore, age, body mass index, haemoglobin, total white blood cell count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, serum creatinine, D-dimer, C-reactive protein, random blood sugar, spontaneous oxygen saturation and respiratory rate were found to be strongly correlated with the severity and mortality of COVID-19 infection (P values< 0.05). Among the different biomarkers studied, the most reliable predictors of COVID-19 infection severity and mortality were the neutrophil-lymphocyte ratio (for severity; aOR = 8.060, AUC = 0.81 and for mortality; aOR = 4.139, AUC = 0.85) and D-dimer level (for severity; aOR = 4.695, AUC = 0.77, and for mortality; aOR = 3.508, AUC = 0.82). Conclusions: This study identified several independent, inexpensive, simple, and important biomarkers of COVID-19 infection that can be used for patient stratification and resource allocation, especially in resource-limited settings. | ||
Keywords | ||
COVID-19 infection; predictor; severity; mortality; D-dimer | ||
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