P1550: haematological predictors of poor outcome among covid-19 patients admitted to an intensive care unit of a south african tertiary hospital

Topic: 30. Infections in hematology (incl. supportive care/therapy) Background: Studies from Asia, Europe and the USA indicate that widely available haematological parameters could be used to determine the clinical severity of Coronavirus disease 2019 (COVID-19) and predict management outcomes. There is limited date from Africa on their usefulness in patients admitted to intensive care units (ICUs). We performed an evaluation of baseline haematological parameters as prognostic biomarkers in ICU COVID-19 patients. Aims: To evaluate baseline “routine” haematological parameters in patients admitted to the ICU of a tertiary academic hospital during the first and second COVID-19 waves and correlate these to the disease severity and outcome. Methods: Demographic, clinical and laboratory data were collected prospectively on patients with confirmed COVID-19, admitted to the adult ICU at Tygerberg Hospital, the 1384 bed teaching hospital for Stellenbosch University Faculty of Medicine and Health Sciences. The study period was March 2020 to February 2021. Robust Poisson regression methods and receiver operating characteristic (ROC) curves were used to explore the association between haematological parameters and COVID-19 severity and mortality. Results: A total of 490 patients (median age 54.1 years) were included of whom 237(48%) were female. The median duration of ICU stay was 6 days and 309/490 (63%) patients died. Raised neutrophil counts and neutrophil/lymphocyte ratios (NLR) were associated with worse outcomes. Independent risk factors associated with mortality were age (ARR 1.01, 95% CI 1.0-1.02; female sex (ARR 1.23, 95% CI 1.05-1.42; p=0.008) and D-dimer levels (ARR 1.01, 95% CI 1.002-1.03; p=0.016). Summary/Conclusion: Our study showed that raised neutrophil count, NLR and D-dimer at the time of ICU admission were associated with higher mortality. Contrary t what has been previously reported, our study revealed that females admitted to the ICU had a higher risk of mortality than males. Keywords: COVID-19, Neutropenia, Lymphocyte, Prognostic factor