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Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment

  • Authors:
    • Stelios Kokkoris
    • Angeliki Kanavou
    • Dimitrios Katsaros
    • Stavros Karageorgiou
    • Panagiotis Kremmydas
    • Aikaterini Gkoufa
    • Theodora Ntaidou
    • Charalampos Giannopoulos
    • Marina-Areti Kardamitsi
    • Georgia Dimopoulou
    • Evangelia Theodorou
    • Vasiliki Epameinondas Georgakopoulou
    • Demetrios A. Spandidos
    • Stylianos Orfanos
    • Anastasia Kotanidou
    • Christina Routsi
  • View Affiliations / Copyright

    Affiliations: First Department of Intensive Care, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece, Department of Infectious Diseases, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
    Copyright: © Kokkoris et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 12
    |
    Published online on: November 28, 2023
       https://doi.org/10.3892/br.2023.1700
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Abstract

Although coronavirus disease 2019 (COVID‑19)-induced changes in laboratory parameters in patients upon admission have been well‑documented, information on their temporal changes is limited. The present study describes the laboratory trends and the effect of dexamethasone treatment on these parameters, in patients with COVID‑19 in the intensive care unit (ICU). Routine laboratory parameters, namely white blood cell (WBC), neutrophil, lymphocyte and platelet (PLT) counts, fibrinogen, C‑reactive protein (CRP), lactate dehydrogenase (LDH) and albumin concentrations, were recorded upon admission to the ICU and, thereafter, on days 3, 5, 10, 15 and 21; these values were compared between survivors and non‑survivors, as well as between those who were treated with dexamethasone and those who were not. Among the 733 patients in the ICU, (mean age, 65±13 years; 68% males; ICU mortality rate 45%; 76% of patients treated with dexamethasone), the WBC and neutrophil counts were persistently high in all patients, without significant differences over the first 15 days. Initially, low lymphocyte counts exhibited increasing trends, but remained higher in survivors compared to non‑survivors (P=0.01). The neutrophil‑to‑lymphocyte ratio (NLR) was persistently elevated in all patients, although it was significantly higher in non‑survivors compared to survivors (P<0.001). The PLT count was initially increased in all patients, although it was significantly decreased in non‑survivors over time. The fibrinogen and LDH values remained similarly elevated in all patients. However, the increased levels of CRP, which did not differ between patients upon admission, further increased in non‑survivors compared to survivors after day 10 (P=0.001). Declining trends in albumin levels over time, overall, with a significant decrease in non‑survivors compared to survivors, were observed. Dexamethasone treatment significantly affected the temporal progression of fibrinogen and CRP in survivors and that of NLR in non‑survivors. On the whole, the present study demonstrates that patients in the ICU with COVID‑19 present persistently abnormal laboratory findings and significant differences in laboratory trends of NLR, CRP, PLT and albumin, but not in WBC and neutrophil count, and fibrinogen and LDH levels, between survivors and non‑survivors. The temporal progression of fibrinogen, CRP and NLR is affected by dexamethasone treatment.
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Copy and paste a formatted citation
Spandidos Publications style
Kokkoris S, Kanavou A, Katsaros D, Karageorgiou S, Kremmydas P, Gkoufa A, Ntaidou T, Giannopoulos C, Kardamitsi M, Dimopoulou G, Dimopoulou G, et al: Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment. Biomed Rep 20: 12, 2024.
APA
Kokkoris, S., Kanavou, A., Katsaros, D., Karageorgiou, S., Kremmydas, P., Gkoufa, A. ... Routsi, C. (2024). Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment. Biomedical Reports, 20, 12. https://doi.org/10.3892/br.2023.1700
MLA
Kokkoris, S., Kanavou, A., Katsaros, D., Karageorgiou, S., Kremmydas, P., Gkoufa, A., Ntaidou, T., Giannopoulos, C., Kardamitsi, M., Dimopoulou, G., Theodorou, E., Georgakopoulou, V. E., Spandidos, D. A., Orfanos, S., Kotanidou, A., Routsi, C."Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment". Biomedical Reports 20.1 (2024): 12.
Chicago
Kokkoris, S., Kanavou, A., Katsaros, D., Karageorgiou, S., Kremmydas, P., Gkoufa, A., Ntaidou, T., Giannopoulos, C., Kardamitsi, M., Dimopoulou, G., Theodorou, E., Georgakopoulou, V. E., Spandidos, D. A., Orfanos, S., Kotanidou, A., Routsi, C."Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment". Biomedical Reports 20, no. 1 (2024): 12. https://doi.org/10.3892/br.2023.1700
Copy and paste a formatted citation
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Spandidos Publications style
Kokkoris S, Kanavou A, Katsaros D, Karageorgiou S, Kremmydas P, Gkoufa A, Ntaidou T, Giannopoulos C, Kardamitsi M, Dimopoulou G, Dimopoulou G, et al: Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment. Biomed Rep 20: 12, 2024.
APA
Kokkoris, S., Kanavou, A., Katsaros, D., Karageorgiou, S., Kremmydas, P., Gkoufa, A. ... Routsi, C. (2024). Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment. Biomedical Reports, 20, 12. https://doi.org/10.3892/br.2023.1700
MLA
Kokkoris, S., Kanavou, A., Katsaros, D., Karageorgiou, S., Kremmydas, P., Gkoufa, A., Ntaidou, T., Giannopoulos, C., Kardamitsi, M., Dimopoulou, G., Theodorou, E., Georgakopoulou, V. E., Spandidos, D. A., Orfanos, S., Kotanidou, A., Routsi, C."Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment". Biomedical Reports 20.1 (2024): 12.
Chicago
Kokkoris, S., Kanavou, A., Katsaros, D., Karageorgiou, S., Kremmydas, P., Gkoufa, A., Ntaidou, T., Giannopoulos, C., Kardamitsi, M., Dimopoulou, G., Theodorou, E., Georgakopoulou, V. E., Spandidos, D. A., Orfanos, S., Kotanidou, A., Routsi, C."Temporal trends in laboratory parameters in survivors and non‑survivors of critical COVID‑19 illness and the effect of dexamethasone treatment". Biomedical Reports 20, no. 1 (2024): 12. https://doi.org/10.3892/br.2023.1700
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