Table 1.
Cohort demographics are presented as counts and percentages (%) for categorical data and means with interquartile range for continuous data
| Condition | Severity | Outcome | Disease | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mild | Intermediate | Severe | P value | Discharged | Deceased | P–v | Control | Disease | P v | |
| N | 28 | 23 | 44 | 72 | 23 | 46 | 95 | |||
| Male | 16 (57%) | 11 (48%) | 26 (59%) | 38 (53%) | 15 (65%) | 23 (50%) | 53 (56%) | |||
| Female | 12 (43%) | 12 (52%) | 18 (41%) | 34 (47%) | 8 (35%) | 23 (50%) | 42 (44%) | |||
| Age | 53.0 (33.8–71.2) | 65.7 (62.5–77.5) | 67.7 (57.8–81.2) | * | 59.6 (45.8–74.5) | 73.1 (62.5–86.0) | *** | 64.0 (57.0–78.8) | 62.9 (51.5–77.0) | |
| BMI | 22.7 (20.1–24.1) | 26.4 (23.7–28.0) | 31.6 (25.5–36.9) | *** | 27.6 (22.6–30.9) | 28.8 (25.7–31.3) | 24.4 (20.6–27.4) | 27.9 (23.3–31.4) | ** | |
| Hypertension | 6 (21%) | 4 (17%) | 23 (52%) | *** | 21 (29%) | 12 (52%) | 17 (37%) | 33 (35%) | ||
| Cardiac disease | 3 (11%) | 4 (17%) | 17 (39%) | ** | 14 (19%) | 10 (43%) | * | 14 (30%) | 24 (25%) | |
| Kidney disease | 1 (3.6%) | 4 (17.4%) | 14 (31.8%) | ** | 10 (14%) | 9 (39%) | * | 8 (17%) | 19 (20%) | |
| Liver disease | 4 (14.3%) | 2 (8.7%) | 2 (4.5%) | 6 (8.3%) | 2 (8.7%) | 4 (8.7%) | 8 (8.4%) | |||
| Malignancy | 3 (10.7%) | 5 (21.7%) | 4 (9.1%) | 9 (12%) | 3 (13%) | 12 (26%) | 12 (13%) | |||
| 4C score | 5.19 (2.50–8.5) | 9.55 (8.25–11.8) | 12.00 (9.00–14.5) | *** | 8.24 (4–11) | 13.14 (12–15) | *** | |||
| O2 support | 1 (3.6%) | 23 (100.0%) | 44 (100.0%) | *** | 45 (62%) | 23 (100%) | *** | |||
| Mechanical respiratory support | 0 (0%) | 0 (0%) | 22 (50%) | *** | 15 (21%) | 7 (30%) | ||||
| Max FiO2 | 20.4 (221) | 30.0 (28–32) | 78.7 (60–100) | *** | 41.8 (21–60) | 74.5 (38–100) | *** | |||
| Required O2 on presentation | 0 (0%) | 13 (57%) | 36 (82%) | *** | 33 (46%) | 16 (70%) | * | |||
| FiO2 (%) on presentation | 21.0 (21–21) | 24.6 (21–28) | 45.2 (27–60) | *** | 31.1 (21–28) | 39.2 (21–40) | ||||
| ITU stay | 0 (0%) | 0 (0%) | 12 (27%) | *** | 6 (8.3%) | 6 (26.1%) | ||||
| NEWS | 1.50 (0.0–3.0) | 4.09 (2.5–5.5) | 6.93 (6.0–8.5) | *** | 4.03 (1.0–7.00) | 6.55 (4.5–8.75) | ** | |||
| eGFR | 79.5 (74.5–90.0) | 70.7 (60.0–90.0) | 58.5 (37.5–86.2) | *** | 72.6 (59.8–90.0) | 52.1 (31.0–81.5) | ** | |||
| Fever | 15 (54%) | 12 (52%) | 29 (66%) | 41 (57%) | 15 (65%) | |||||
| Cough | 15 (54%) | 17 (74%) | 27 (61%) | 45 (62%) | 14 (61%) | |||||
| SOB | 13 (46%) | 16 (70%) | 36 (82%) | ** | 47 (65%) | 18 (78%) | ||||
| Pulse (BPM) | 92.5 (80.5–103) | 93.4 (82.0–108) | 98.6 (83.0–112) | 95 (80.5–108) | 97 (87.2–112) | |||||
| Temp. (℃) | 37.1 (36.6–37.3) | 37.3 (36.6–37.7) | 37.4 (36.8–38.0) | 37.3 (36.7–37.5) | 37.3 (36.6–37.6) | |||||
| BP (mmHg) | 131 (110–141) | 131 (114–150) | 127 (110–143) | 132 (112–149) | 122 (106–138) | |||||
| Respiratory rate | 18.7 (17.8–20.0) | 20.8 (18.0–22.5) | 25.8 (21.0–30.0) | *** | 21.8 (18–24.0) | 24.8 (20–29.5) | * | |||
| Hb (g/L) Male [133–168] Female [118–148] | 135 (120–151) | 136 (126–146) | 126 (117–141) | * | 135 (123–148) | 118 (99–142) | * | |||
| WBC (× 109/L) [3.5–11.0] | 7.74 (5.35–9.95) | 9.20 (5.00–10.15) | 8.45 (5.68–10.25) | 8.40 (5.35–9.9) | 8.49 (5.35–10.9) | |||||
| Lymphs (× 109/L) [1.0–3.5] | 1.46 (0.7–1.45) | 1.85 (0.7–1.60) | 1.19 (0.5–1.63) | 1.607 (0.7–1.72) | 0.874 (0.4–0.90) | ** | ||||
| PLTS (× 109/L) [150–400] | 238 (179–281) | 243 (175–292) | 249 (176–301) | 245 (176–290) | 242 (178—301) | |||||
| HCT (%) | 0.393 (0.351–0.444) | 0.405 (0.380–0.435) | 0.375 (0.352–0.421) | 0.398 (0.368–0.434) | 0.355 (0.298–0.428) | * | ||||
| ALT (U/L) Male [≤ 41] Female [≤ 33] | 32.8 (16–35.0) | 37.5 (22–40.5) | 39.1 (18–33.8) | 35.7 (18–37) | 40.7 (14–31) | |||||
| Urea (mmol/L) [2.5–7.8] | 5.08 (3.20–5.93) | 6.93 (5.10–6.80) | 11.76 (4.57–15.47) | *** | 7.09 (4.18–7.7) | 13.43 (5.80–18.9) | ** | |||
| Creatinine (µmol/L) Male [59–104] Female [45–84] | 74.5 (55.5–89.2) | 102.7 (64.0–94.0) | 134.5 (69.2–139.5) | * | 91.1 (62.8–96) | 165.6 (71.5–180) | * | |||
| CRP (mg/L) [< 4] | 40.5 (3.0—72) | 82.7 (33.0–104) | 132.4 (67.5–171) | *** | 80.1 (18.0–111) | 133.9 (67.5–171) | * | |||
P-values indicating significant differences between groups follow ‘star’ notation i.e., ‘***’ correspond to p-values < 0.001, ‘**’ < 0.01, ‘*’ < 0.05, ‘.’ < 0.1 and missing when > 0.1. P-values for severity were calculated by comparing severe case to the combined population of mild and intermediate cases. The study compared 46 control individuals to 95 COVID-19 patients. Only limited clinical information was available for the control population. From the COVID-19 cohort 44 patients developed severe symptoms and 23 patients died as a result of the infection. Some disparity can be observed in gender as women represent 41% of the severe cases and only 35% of the deceased patients. It can be noted that severe case and poor outcome groups have higher mean age; however, groups are well balanced in age between the control and COVID-19 cohorts. BMI differences are significant in severity and disease, but not in outcome. Hypertension showed significant in severity but not in outcome. Cardiac disease refers to multiple cardiovascular conditions, most frequently: ischemic heart disease, atrial fibrillation, and heart failure. Kidney disease is a grouping of stages G2 to G5 of chronic kidney disease as defined by the National Institute for Health and Care Excellence NICE (2015). Liver disease in most cases refers to cirrhosis and hepatitis. Malignancy cases vary from lung, bladder, prostate, skin cancer to haematological. Those underlying conditions did not show significant differences in severe infections or poor outcome. Severity score metrics based on the 4C Mortality score (Knight et al., 2020) are provided as group means. O2 support indicates the number of patients that required oxygen support at any time during their hospitalization. Mechanical respiratory support indicates the need of invasive support or continuous positive airway pressure (CPAP). Max FiO2 captures the maximum fraction of inspired oxygen required by the patient during the hospitalization period, where respiratory support captures the patients requiring any support at diagnosis and FiO2 represents the fraction of inspired oxygen required at time of sample acquisition. As expected, oxygen need and inspired fraction, are highly correlated with severity and in some cases with fatal outcome. National Early Warning Score (NEWS) also showed correlation with both severity and outcome. Despite kidney disease classification not showing correlation, estimated Glomerular Filtration Rate (eGFR) levels were significantly different across severity and outcome classes. Fever (temperature ≥ 38 °C), cough, shortness of breath (SOB), pulse and systolic blood pressure (BP) were noted at time of sample acquisition and did not show relation to severity or outcome. Respiratory rate also taken at samples acquisition showed correlation with severity. Haemoglobin levels (Hb), white blood cell count (WBC), lymphocyte count (Lymphs), platelets count (PLTs), haematocrit (HCT) and alanine aminotransferase (ALT) measured at sample acquisition did not show significant correlation with severity and outcome except Hb in outcome. Urea, creatinine, and C-reactive protein (CRP) concentrations are consistently elevated in severe and deceased patients. Hb, WBC, Lymphs, PLTs and HCT were measured on Beckman Coulter DxH800. ALT, urea, creatinine and CRP were measured on a Roche immunoturbidimetric assay on COBAS e602 platform. Reference ranges for normal population are provided in square brackets [] when available