The study was approved by the local clinical ethics committee. Ninety patients who admitted to the emergency department between June 2021 and June 2022 and were diagnosed with COVID-19 were included in the study. The COVID-19 test was carried out by taking a nasopharyngeal swab, and samples were analyzed with real-time PCR.
The hospital records of the patients were retrospectively reviewed by the responsible clinicians. Patient data, including laboratory investigations, medical history, comorbid conditions, complications, demographics, treatments initiated, and outcomes, were collected and carefully analyzed.
Ninety patients were divided into three groups according to disease severity: mild, moderate and severe; each group consisted of 30 patients. The classification of the patients according to their weight was made according to the current adult diagnosis and treatment guideline of the Ministry of Health of the Republic of Turkey, COVID-19. The mild group consisted of out-patients with normal chest X-ray images. The moderate group consisted of patients treated by hospitalization with pneumonia (not severe pneumonia). The severe group consisted of patients treated in intensive care units with macrophage activation syndrome and severe pneumonia that fit any of the following conditions: respiratory rate ≥ 30 breaths/min, SpO2 ≤ 92%, and pulmonary infiltration rate >50%.
q-SOFA scores were determined in the first 24 hours of admission [10]. A high q-SOFA score was defined as a q-SOFA score ≥ 2, while a low score was defined as a q-SOFA score <2. Parameters used in q-SOFA scoring are decreased mental status (GCS<15), increased respiratory rate (≥22/min), and decreased systolic blood pressure (<100 mmHg), and each parameter is one point 12.
The inclusion criteria were age 18 and 75 years and female and male sex diagnosed with COVID-19. The exclusion criteria are; patients who were not diagnosed with COVID-19 and who developed complications due to their comorbidities despite being diagnosed with COVID-19 were excluded from the study. In addition, patients who had trauma, whose data could not be accessed or who had missing data were not included in the study.
Statistical Analyses
The minimum number of patients required for the study was calculated in the G Power sample calculation program (version 3.1.9.4). Since there is no available study in the literature similar to this study, Cohen’s effect size was used (Cohen, J. (1988). Statistical power analysis fort he behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum). G-power program inputs were: a priori calculation for one-way anova test, α =0.05, power (1-β): 0.92, effect size 0.40 (large). Accordingly, the minimum sample size was calculated as 30 for each group, a total of 90 patients.
Statistical analyses were performed by using SPSS 25.0 package program (SPSS, Chicago). The normality of the data was checked with the Kolmogorov‒Smirnov test. The mean±standard deviation was used for normally distributed data, and the median (minimum-maximum) was used for nonnormally distributed data. Comparisons of biochemical results of groups for normally distrubuted parameters were performed by using one-way ANOVA test. A post hoc Tukey test was used to determine the differences between subgroups following one-way ANOVA. Comparisons of biochemical results of three groups for non-normally distrubuted biochemical and hematological parameters and q-SOFA scores were performed with the Kruskal‒Wallis test, and the Mann‒Whitney U test with Bonferroni correction was used to perform pairwise comparisons. Binary logistic regression analysis was performed to examine the effect of the q-SOFA score on mortality.
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