lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Laboratory Predictors for COVID-19 Intensive Care Unit Admissions in Trinidad and Tobago

26 Pages Posted: 24 Jan 2022

See all articles by Chavin D. Gopaul

Chavin D. Gopaul

North Central Regional Health Authority

Dale Ventour

University of the West Indies (Saint Augustine)

Davlin Thomas

North Central Regional Health Authority

More...

Abstract

Understanding symptoms associated with COVID-19 cases requiring intensive care unit(ICU) attention is important in management of the life-threatening cases of the disease. This study aimed to determine laboratory indicators of ICU admission for COVID-19 patients. For this retrospective chart review study, data from 116 patients(ICU, n=18, Non-ICU, n=98) with confirmed SARS-CoV-2, managed at two hospitals in Trinidad and Tobago, from March 12th to April 12th 2020, were analyzed. The median age of non-ICU patients was 59.0(IQR=23.5) years; ICU patients had a median age of 62.5(IR=17.5). From univariate analysis, laboratory indicators significantly associated with ICU admission included WBC(P=0.037), lymphocyte(P=0.016), LDH(P=0.002), AST(P=0.005) and CRP(P = 0.0001). However, multivariate analysis including WBC, neutrophil, lymphocyte, PLT, AST, LDH, ALT and CRP indicated that only AST was associated with high odds of ICU admission(OR .002, 95% CI 0.000-.004, P=0.017). Statistically significant AUC were obtained for neutrophil(AUC = 0.704, P = 0.007), CRP (AUC=0.81, p=0.00) and LDH(AUC=0.766, P=0.00) and AST (AUC=0.729, P=0.003). The findings indicate that neutrophils, AST and LDH’s ROC curves are good tests, CRP curve is a very good test, but lymphocyte curve is a poor test, in determining COVID-19 patients for ICU admission. Neutrophil, AST, LDH and CRP are suitable predictors of COVID-19 patients that should receive intensive unit care. The study provides significant insights into laboratory parameters that can be used to predict COVID-19 severity and important considerations for healthcare providers in making evidence-based decisions regarding COVID-19 patient management, especially in the context of limited ICU facilities. This study was not funded.

Funding Information: The authors have not received any funding or benefits from industry or elsewhere to conduct this study.

Declaration of Interests: The authors declare that there are no conflicts of interest

Ethics Approval Statement: This study was granted ethical approval by the following ethics committees: The North Central Regional Health Authority Ethics Committee, Trinidad– approval granted The Ministry of Health of Trinidad and Tobago (3/13/441 Vol. II) Ethics Committee – approval granted. Participant consent was waived by the ethics committees due to the exclusive use of de-identified data, which was entered in this study-specific database, and solicited through the ethics committees. No participant identifiers (name, address, telephone or cell phone number/email/any contact information, ID numbers) were collected nor used for the purpose of this study.

Keywords: Biomarkers, COVID-19, intensive care unit ICU, SARS-CoV-2, Trinidad and Tobago

Suggested Citation

Gopaul, Chavin D. and Ventour, Dale and Thomas, Davlin, Laboratory Predictors for COVID-19 Intensive Care Unit Admissions in Trinidad and Tobago. Available at SSRN: https://ssrn.com/abstract=4016527 or http://dx.doi.org/10.2139/ssrn.4016527

Chavin D. Gopaul (Contact Author)

North Central Regional Health Authority ( email )

Trinidad and Tobago

Dale Ventour

University of the West Indies (Saint Augustine) ( email )

St. Augustine
Cave Hill Campus
Saint Augustine, 868
Trinidad and Tobago

Davlin Thomas

North Central Regional Health Authority ( email )

Trinidad and Tobago