Prognostic Biomarkers in COVID-19: Prediction of Critical Outcomes and Mortality

COVID-19, caused by the SARS-CoV-2 coronavirus, emerged as a global pandemic in 2020, with profound impacts on public health and a substantial burden on intensive care units (ICUs). Because critically ill patients are at increased risk of rapid clinical deterioration and death, there is a need for reliable early prognostic biomarkers to support risk stratification and optimize clinical management. Therefore, this study investigated whether clinical and laboratory parameters obtained at hospital admission could serve as prognostic biomarkers for endotracheal intubation and mortality in critically ill patients with COVID-19 admitted to ICUs. A retrospective analytical study was conducted using the medical records of 107 critically ill patients with confirmed COVID-19 admitted to ICUs. Patients were classified according to clinical outcome as survivors (n = 22) or non-survivors (n = 85). Clinical characteristics and laboratory biomarkers obtained at hospital admission were analyzed. D-dimer, lactate dehydrogenase (LDH), red cell distribution width (RDW), the AST/ALT ratio, and age were independently associated with mortality. In addition, D-dimer and LDH demonstrated moderate discriminatory performance for predicting the need for endotracheal intubation. These findings suggest that routinely available clinical and laboratory parameters obtained at hospital admission may serve as complementary prognostic biomarkers to support early risk stratification and clinical decision-making in critically ill patients with COVID-19. Nevertheless, prospective multicenter studies are warranted to externally validate these findings and further establish their clinical applicability.