Comparative assessment of mortality risk factors between admission and follow-up models among patients hospitalized with COVID-19

Abstract

Objectives We aim to compare differences in mortality risk factors between admission and follow-up incorporated models. Methods A retrospective cohort study with 524 patients with confirmed COVID-19 infection admitted to a tertiary medical center in São Paulo, Brazil, from March 13 th to April 30 th , 2020. We collected data at admission, 3 rd , 8 th and 14 th day of hospitalization. We calculated the hazard ratio (HR) and compared 28-day in-hospital mortality risk factors between admission and follow-up models using a time-dependent Cox regression model. Results Of 524 patients, 50.4% needed mechanical ventilation. The 28-day mortality rate was 32.8%. Compared to follow-up, admission models under-estimated the mortality HR for peripheral oxygen saturation<92% (1.21 versus 2.09), heart rate>100bpm (1.19 versus 2.04), respiratory rate>24ipm (1.01 versus 1.82) and mechanical ventilation (1.92 versus 12.93). Low oxygen saturation, higher oxygen support and more biomarkers including lactate dehydrogenase, c-reactive protein, neutrophil-lymphocyte ratio and urea remained associated with mortality after adjustment for clinical factors at follow-up compared to only urea and oxygen support at admission. Conclusions The inclusion of follow-up measurements changed mortality hazards of clinical signs and biomarkers. Low oxygen saturation, higher oxygen support, lactate dehydrogenase, c-reactive protein, neutrophil-lymphocyte ratio and urea could help prognose patients during follow-up.

Probability of hospitalisation and death among COVID-19 patients with comorbidity during outbreaks occurring in Mexico City

“…Based on our results, the results of the study carried out by our group in the tertiary care hospital [ 23 ] and the results of other recently published studies [ 30 ], we consider that it is necessary to carry out the following measures to avoid an increase in the rates of lethality in hospitalized patients. The first measure is, without a doubt, to intensify public health measures shown to decrease transmission (use of face masks, social distancing, and continuous application of hygiene measures).…”

Impacto de Marcadores Inflamatórios no Prognóstico de Pacientes Oncológicos Internados no Instituto Nacional de Câncer com SARS-CoV-2 na Primeira Onda da Pandemia no Brasil

“…Outros estudos internacionais têm apontado para a utilidade de diversos índices inflamatórios para prever a mortalidade em pacientes com covid-19 [4][5][6] . No Brasil, de forma semelhante, o número absoluto de leucócitos 9,14 , neutrófilos 9,14 , linfócitos 9,11,14 , basófilos 11 , hematócrito 11 , hemoglobina 14 , RNL 9,11,15 , dRNL 15 , PLR [11][12][13][14] , razão neutrófilos-plaquetas (RNP) 11,15 , razão monócito-linfócito (RML) 9 e índice de inflamação sistêmica (IIS) 11,15 têm sido preditores de gravidade, necessidade de internação em UTI ou óbito em diferentes cenários 9,[11][12][13][14][15] . Diferentemente, um estudo mostrou que a RNL não esteve associada à maior gravidade ou óbito 10 .…”

“…No entanto, não há consenso sobre a sua associação com a gravidade da doença e com o risco de morte 8 . Diversos estudos brasileiros têm analisado a importância desses marcadores como preditores de gravidade ou óbito em pacientes com covid-19 [9][10][11][12][13][14][15] . Entretanto, até o presente momento, nenhum estudo nacional avaliou sua utilidade em pacientes com câncer.…”

Ivermectin for treatment of COVID-19: A systematic review and meta-analysis

“…Multiple clinical trials have been conducted to evaluate clinical outcomes [ [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] ], with contradictory outcomes, and some of these studies have been withdrawn or retracted for fear of serious data inconsistencies or research fraud [ [27] , [28] , [29] ]. It is imperative to synthesize evidence for clinicians and communities.…”