Prognostic factors for the severe course of COVID-19 in the different COVID-19 peak periods in Central Kazakhstan

Lyudmila Turgunova 1, Irina Mekhantseva 1 * , Irina Bacheva 1, Dana Amirkhanova 1, Maria Butyugina 1, Nadezhda Samoilova 1
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1 Department of Internal Medicine, Karaganda Medical University, Karaganda, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 19, Issue 4, pp. 53-58.
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Introduction: COVID-19 has become the cause of a pandemic that has swept the entire world. Considering the genetic variability of the virus, the development and implementation of antiviral therapies, and the acquisition of a society's immune defenses through past infection or vaccination, the course of COVID-19 may change over time. The research aim was to study the prognostic significance of clinical and laboratory parameters with severe COVID-19 in 2020 and 2021 in Central Kazakhstan. 
Material and methods: A cohort of 1556 patients with COVID-19 admitted to the infection hospitals of Karaganda from May to July 2020 and 2021 year was retrospectively analyzed. The association of clinical and laboratory parameters with the severe disease was analyzed using univariate and multivariate logistic regression, and independent predictors were established for each factor. 
Results: The comparative analysis of the prognostic significance of demographic, clinical, and laboratory parameters in different periods of the pandemic showed a reduction in developing severe COVID-19 among hospitalized patients in 2021 compared to 2020. The essential value of comorbidity, especially chronic renal failure, and chronic heart failure remained significant against the background of decreasing prognostic significance of age, gender, and clinical and laboratory indicators of inflammation for the severe course of COVID-19.


Turgunova L, Mekhantseva I, Bacheva I, Amirkhanova D, Butyugina M, Samoilova N. Prognostic factors for the severe course of COVID-19 in the different COVID-19 peak periods in Central Kazakhstan. J CLIN MED KAZ. 2022;19(4):53-8.


  • Balakrishnan VS. COVID-19 response in central Asia. The Lancet Microbe. 2020;1(7): 281.
  • Yegorov S, Goremykina M, Ivanova R, Good SV, Babenko D, Shevtsov A, et al. Epidemiology, clinical characteristics, and virologic features of COVID-19 patients in Kazakhstan: A nation-wide retrospective cohort study. The Lancet Regional Health – Europe. 2021;4:100096.
  • Zhalmagambetov B, Madikenova M, Paizullayeva S, Abbay A, Gaipov A. COVID-19 Outbreak in Kazakhstan: Current Status and Challenges. Journal of Clinical Medicine of Kazakhstan. 2020; 1(55):6–8.
  • Hu Y, Sun J, Dai Z, Deng H, Li X, Huang Q, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. Journal of Clinical Virology. 2020;127:104371.
  • Shi C, Wang L, Ye J, Gu Z, Wang S, Xia J, et al. Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis. BMC Infectious Diseases. 2021;21(1):663.
  • Macedo A, Gonçalves N, Febra C. COVID-19 fatality rates in hospitalized patients: systematic review and meta-analysis. Annals of Epidemiology. 2021;57:14–21.
  • Gallo V, Chiodini P, Bruzzese D, Kondilis E, Howdon D, Mierau J, et al. Comparing the COVID-19 pandemic in space and over time in Europe, using numbers of deaths, crude rates and adjusted mortality trend ratios. Scientific Reports. 2021;11(1):16443.
  • Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? The Lancet. 2020;395(10231):1225–1228.
  • Velazquez S, Madurga R, Castellano JM, Rodriguez-Pascual J, Aguiar Diaz Obregon SR, Jimeno S, et al. Hemogram-derived ratios as prognostic markers of ICU admission in COVID-19. BMC Emergency Medicine. 2021;21(1):89.
  • Timpau, AS, Miftode RS, Petris AO, Costache II, Miftode IL, Rosu FM, et al. Mortality Predictors in Severe COVID-19 Patients from an East European Tertiary Center: A Never-Ending Challenge for a No Happy Ending Pandemic. Journal of Clinical Medicine. 2021;11(1):58.
  • Bastug A, Bodur H, Erdogan S, Gokcinar D, Kazancioglu S, Kosovali BD, et al. Clinical and laboratory features of COVID-19: Predictors of severe prognosis. International Immunopharmacology. 2020;88:106950.
  • Agency for Strategic planning and reforms of the Republic of Kazakhstan Bureau of National statistics. Available online: (Accessed January 11, 2022).
  • Radovanovic D, Seifert B, Urban P, Eberli FR, Rickli H, Bertel O, et al. Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012. Heart. 2014;100(4):288–294.
  • Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, et al. Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts Using Data From 6 Countries. American Journal of Epidemiology. 2011;173(6):676–682.
  • Semenova Y, Glushkova N, Pivina L, Khismetova Z, Zhunussov Y, Sandybaev M, Ivankov A. Epidemiological Characteristics and Forecast of COVID-19 Outbreak in the Republic of Kazakhstan. J Korean Med Sci. 2020;35(24):e227.
  • Vafadar ME, Teimouri A, Rezaee R, Morovatdar N, Foroughian M, Layegh P, et al. Increased age, neutrophil-to-lymphocyte ratio (NLR) and white blood cells count are associated with higher COVID-19 mortality. The American Journal of Emergency Medicine. 2021;40:11–14.
  • Jin JM, Bai P, He W, Wu F, Liu XF, Han DM, et al. Gender Differences in Patients With COVID-19: Focus on Severity and Mortality. Frontiers in Public Health. 2020;8.
  • Callender LA, Curran M, Bates SM, Mairesse M, Weigandt J, Betts CJ. The Impact of Pre-existing Comorbidities and Therapeutic Interventions on COVID-19. Frontiers in Immunology. 2020;11.
  • Thakur B, Dubey P, Benitez J, Torres JP, Reddy S, Shokar N, et al. A systematic review and meta-analysis of geographic differences in comorbidities and associated severity and mortality among individuals with COVID-19. Scientific Reports. 2021;11(1):8562.
  • Kılıç M, Tekyol D. The impact of the COVID-19 pandemic on critically ill patients with acute stroke and diabetic ketoacidosis. Eur J Clin Exp Med. 2022;20(2):146–150. https://doi:10.15584/ejcem.2022.2.2
  • Sun Y, Dong Y, Wang L, Xie H, Li B, Chang C, et al. Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience. Journal of Autoimmunity. 2020;112:102473.
  • Sarkar S, Khanna P, Singh AK. The Impact of Neutrophil-Lymphocyte Count Ratio in COVID-19: A Systematic Review and Meta-Analysis. Journal of Intensive Care Medicine. 2021;088506662110456.
  • Gelzo M, Cacciapuoti S, Pinchera B, de Rosa A, Cernera G, Scialò F, et al. Prognostic Role of Neutrophil to Lymphocyte Ratio in COVID-19 Patients: Still Valid in Patients That Had Started Therapy? Frontiers in Public Health. 2021;9.