The possibility of predicting the COVID-19 severity by clinical-laboratory criteria taking into account the SARS-CoV-2 strain: An analytical review

Abstract

The survival of patients with severe COVID-19 depends on timely and adequate assessment of the risk of adverse disease outcomes. Currently, conflicting data on the prognostic value of various laboratory parameters in severe COVID-19 caused by different SARS-CoV-2 variants require analysis and systematization. The leading clinical and laboratory signs that determine the severity of COVID-19 include the syndrome of systemic inflammatory reaction and hemostasis disorders, which, in conditions of high viral load, hypoxia, and toxic exposure, contribute to the development of cytolytic syndrome, cytopenia, and multiple organ failure. Biological and immunological features of SARS-CoV-2 variants have an important influence on the severity of the infection. Based on literature sources, we have listed the most significant laboratory parameters, which, combined with clinical criteria, serve as an accurate guide for physicians both in monitoring patients and selecting therapy in Russia and abroad. Some SARS-CoV-2 variants exhibit reduced susceptibility to monoclonal antibodies and recombination plasma, which requires a revision of the therapy strategy. Detailed analysis of pathognomonic laboratory parameters and understanding of the immunological response to a particular SARS-CoV-2 variant will quickly and accurately identify the vulnerable patient groups, timely change in their therapy, and prevent complication development.

Keywords

severe COVID-19 / laboratory predictors / SARS-CoV-2 strains / Wuhan strain / alpha variant / beta variant / gamma variant / delta variant / omicron variant / COVID-19 treatment

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