Analysis of changes in laboratory indexes in case of severe coronavirus infection among patients of different ages
Abstract. Since the end of 2019, coronavirus infection caused by SARS-CoV-2 has resulted in over 777 million clinical cases worldwide and over 6.8 million deaths. This virus had the greatest danger to people over 65 and patients with chronic diseases. For today, data on laboratory indexes’ dynamics in COVID-19 patients has been accumulated, but age-specific patterns of these changes have not been studied.Vertkin A.L., Kebina A.L., Solodov A.A., Levchenko O.V., Yanushevich O.O.
The aim: to study the differences in laboratory parameters in patients with severe coronavirus infection across age groups.
Material and methods. A retrospective, comparative study of laboratory parameters in patients with severe coronavirus infection was performed from 2021 to 2025 at COVID-19 Clinical Center of A.I. Yevdokimov Moscow State Medical University (now Russian University of Medicine) of the Ministry of Healthcare of Russia. The sample consisted of 795 patients (53.6% female and 46.4% male individuals) aged 20 to 90 years (median 70 [61; 80] years), divided into age groups according to WHO criteria. Then a pairwise intergroup analysis of laboratory parameters was performed.
Results. In patients aged 18–44 years, an increase in the median alanine aminotransferase level to 80.75 [41.55; 198.45] U/L was recorded on days 5–7 of hospitalization. Patients aged 60–74 years at the same hospitalization stage were prone to hypoproteinemia, with a median total protein level of 58 [53.2; 62.075] g/L. Patients over 75 years of age were characterized by significant changes in renal function parameters at all stages of hospitalization. The identified changes in these groups can be explained by both the influence of SARS-CoV-2 at organ systems and also the presence of comorbid pathology with its decompensation, which is confirmed by laboratory test results in patients over 75 years of age.
Conclusion. Increasing of the patients’ age is associated with deterioration in protein metabolism, renal function, coagulation disorders, and the development of a “cytokine storm”. Patients over 75 years of age are more likely to have significant laboratory abnormalities indicating a poor prognosis. These obtained data should be considered during outpatient monitoring of individuals who have had severe COVID-19 infection.
Keywords
COVID-19
comparison of patient age groups
comorbidity
hypoproteinemia
renal injury
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About the Authors
Arkady L. Vertkin, MD, Dr. Sci. (Medicine), professor, head of the Department of therapy, clinical pharmacology, and emergency medical care of the Faculty of general medicine of N.A. Semashko Scientific and Educational Institute of Clinical Medicine of Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.E-mail: kafedrakf@mail.ru
ORCID: https://orcid.org/0000-0001-8975-8608. Scopus ID: 7005408337. eLibrary SPIN: 9605-9117
Anastasia L. Kebina, MD, assistant at the Department of therapy, clinical pharmacology, and emergency medical care of the Faculty of general medicine of N.A. Semashko Scientific and Educational Institute of Clinical Medicine of Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: akebina@list.ru
ORCID: https://orcid.org/0000-0002-7570-9650. Scopus ID: 57278863600. eLibrary SPIN: 1173-3423
Alexander A. Solodov, MD, Dr. Sci. (Medicine), director, head of the Department of anesthesiology, resuscitation and intensive care of N.A. Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: docsol@mail.ru
ORCID: https://orcid.org/0000-0002-8263-1433. Scopus ID:24478012600. eLibrary SPIN: 6946-8672
Oleg V. Levchenko, MD, Dr. Sci. (Medicine), professor, vice-rector, head of the Department of neurosurgery of the Faculty of general medicine of N.A. Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: truovl@gmail.com
ORCID: https://orcid.org/0000-0003-0857-9398. Scopus ID: 57209426210. eLibrary SPIN: 7811-8550
Oleg O. Yanushevich, MD, Dr. Sci. (Medicine), professor, academician of RAS, rector, head of the Department of periodontology of A.I. Evdokimov Research and Educational Institute of Dentistry, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: msmsu@msmsu.ru
ORCID: https://orcid.org/0000-0002-4293-8465. Scopus ID: 57131101200. eLibrary SPIN: 1452-1387
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