Assessment of hematology, coagulation, and clinical chemistry parameters in COVID-19 patients: Impact on disease progression and ICU admission in Indonesia

Background The surge of COVID-19 cases in Indonesia has markedly heightened the hospital demand for ICU care. Patients infected by SARS-CoV-2 exhibit discernible changes in laboratory results throughout their infection. This study aimed to assess the progression of COVID-19 infection, ICU admission rate, and patient outcomes by analyzing the profile of laboratory parameters in hospitalized COVID-19 patients. Methods This retrospective cohort involved six hospitals in Jakarta. The inclusion criteria consisted of PCR-confirmed hospitalized COVID-19 patients who underwent laboratory examinations for hematology, hemostasis, clinical chemistry, and infection markers during the pandemic from 2020 to 2021. Results Total of 1865 COVID-19 patients participated in this study, with the majority of 54.16% male patients. Of these patients, 24.23% required ICU care, and 46.23% were aged >60 years old. The mortality rate among COVID-19 patients was 21.87%, with 58.68% of male patients, and 54.9% aged >60 years. Comorbidities such as hypertension, diabetes mellitus, lung diseases, and liver diseases, which aggravate the severity of COVID-19 infection and increase the mortality rate, were observed (p<0.05). The median values of leukocytes, neutrophils, Neutrophil-to-Lymphocyte Ratio (NLR), prolonged prothrombin time (PT), D-dimer, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), urea, creatinine, C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) increased significantly. Conversely, median glomerular filtration rate (eGFR) and lymphocyte values declined with the progression of COVID-19 infection, ICU admission, and non-survival patient outcomes (p< 0.001). Conclusions Patients aged >60 years, with length of stay exceeding 8 days, low Hemoglobin levels, high NLR, low platelet levels, prolonged PT, high D-dimer, high CRP, and elevated IL-6 were correlated with severe COVID-19 infection, ICU admission, and unfavorable patient outcomes. The values of leukocyte count, neutrophil%, NLR, PT, D-dimer, AST, LDH, urea, creatinine, CRP, PCT, and IL-6 increased, while eGFR and lymphocytes decreased in severe COVID-19 infection, ICU admission, and non-survival patient outcome evaluations.