Identification of High Death Risk Coronavirus Disease-19 Patients using Blood Tests

Molavi, Ghader; Hosseingholi, Elaheh Zadeh; Maddahi, Saeede; Jabbari, Sajjad

doi:10.4103/abr.abr_178_21

Cited by 3 publications

(3 citation statements)

References 53 publications

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“…A significant association was found between BUN and mortality risk among COVID-19 patients. Other studies also supported our results since BUN has been previously considered a death-related feature (37). Although COVID-19 impacts mainly the lung, it can also affect the kidney, and the increase in BUN may reflect kidney injury along with other biomarkers.…”

Section: Serum Ferritin Has Been Cited As One Of the Mortality Indica...supporting

confidence: 90%

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Predictors of Mortality in Hospitalized Patients with COVID-19: A One-Year Case-Control Study

Camacho-Domínguez,

Rojas,

Herrán

et al. 2023

Preprint

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Objective: To determine the associated factors with mortality, in addition to age and sex, in a high-complexity hospital in Bogota, Colombia, during the first year of the pandemic. Design: A case-control study. Setting: High-complexity center above 2,640 meters above sea level (masl) in Colombia. Methods: A case-control study was conducted on 564 patients admitted to the hospital with confirmed COVID-19. Deceased patients (n: 282) and a control group (n: 282), matched by age, sex, and month of admission, were included. Clinical and paraclinical variables were retrospectively obtained by systematic revision of clinical records. Multiple imputations by chained equation (MICE) were implemented to account for missing variables. Classification and regression trees (CART) were estimated to evaluate the interaction of associated factors on admission and their role in predicting mortality during hospitalization. Results: Most of the patients included were males in the seventh decade of life. Most of the admissions occurred between July and August 2021. Surprisingly, recovered patients reported heterogeneous symptomatology, whereas deceased patients were most likely to present respiratory distress, dyspnea, and seizures on admission. In addition, the latter group exhibited a higher burden of comorbidities and alterations in laboratory parameters. After the imputation of datasets, CART analysis estimated 14 clinical profiles based on respiratory distress, LDH, dyspnea, hemoglobin, D-dimer, ferritin, blood urea nitrogen, C-reactive protein, PaO2/FiO2, dysgeusia, total bilirubin, platelets, and gastroesophageal reflux disease. The accuracy model for prediction was 85.6% (P < 0.0001). Conclusion: Multivariate analysis yielded a reliable model to predict mortality in COVID-19. This analysis revealed new interactions between clinical and paraclinical features in addition to age and sex. Furthermore, this predictive model could offer new clues for the personalized management of this condition in clinical settings. Keywords: SARS-CoV-2, COVID-19, Mortality, Predictors, Risk Factors

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Section: Serum Ferritin Has Been Cited As One Of the Mortality Indica...supporting

confidence: 90%

“…Although COVID-19 impacts mainly the lung, it can also affect the kidney, and the increase in BUN may reflect kidney injury along with other biomarkers. Moreover, kidney involvement in severe COVID-19 patients has been frequently observed (37,38).…”

Section: Serum Ferritin Has Been Cited As One Of the Mortality Indica...mentioning

confidence: 99%

Predictors of Mortality in Hospitalized Patients with COVID-19: A One-Year Case-Control Study

Camacho-Domínguez,

Rojas,

Herrán

et al. 2023

Preprint

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“…The COVID-19 challenge passed a strong message to the world on the need of building a resilient and sustainable health system [19]. The timely detection of COVID-19 patients with a higher risk of mortality is essential to reduce mortality and for better management of hospital resources [20]. COVID-19 ARDS is a predictable serious complication of COVID-19 that requires early recognition and comprehensive management [21].…”

Section: Discussionmentioning

confidence: 99%

SpO2/FiO2 ratio. A promising index in predicting mortality in COVID-19 patients

Zinna,

Pipitò,

Colomba

et al. 2023

Preprint

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Objectives: identifying high-risk COVID-19 patients is critical for emergency department decision-making. The primary objective of the study was to identify new independent predictors of mortality and their prognostic utility in combination with traditional pneumonia risk assessment scores. Methods: a retrospective study was performed in two Italian University Hospitals. A multivariable logistic model was used to locate independent parameters associated with mortality. Results: age, PaO2/FiO2 (P/F), and SpO2/FiO2 (S/F) ratios were found to be independent parameters associated with 30-day mortality. Study found that PSI was superior to CRB-65 and NEWS in predicting 30-day mortality (AUC: 0.766 vs. 0.763, p=0.981; AUC: 0.766 vs. 0.616, p=0.003). Combination of S/F with CRB-65 and NEWS improved the prognostic accuracy of score compared to “scoring without S/F” (p<0.001 vs. p<0.001 respectively) and compared to PSI (p=0.005 vs. p=0.483 respectively). Combination of P/F with CRB-65 and NEWS produced similar results. Conclusions: in our study, S/F was an independent parameter of 30-day mortality, and being a non-invasive parameter, it could be a valuable tool for staging COVID-19 patients upon admission to the hospital. The combination of S/F and CRB-65 performed similarly to the PSI, and can be a valid alternative to ferruginous PSI calculation and could provide valuable support for decision-makers.

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The SpO2/FiO2 Ratio Combined with Prognostic Scores for Pneumonia and COVID-19 Increases Their Accuracy in Predicting Mortality of COVID-19 Patients

Zinna,

Pipitò,

Colomba

et al. 2024

JCM

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Background: Identifying high-risk COVID-19 patients is critical for emergency department decision-making. Our study’s primary objective was to identify new independent predictors of mortality and their predictive utility in combination with traditional pneumonia risk assessment scores and new risk scores for COVID-19 developed during the pandemic. Methods: A retrospective study was performed in two Italian University Hospitals. A multivariable logistic model was used to locate independent parameters associated with mortality. Results: Age, PaO2/FiO2, and SpO2/FiO2 ratios were found to be independent parameters associated with mortality. This study found that the Pneumonia Severity Index (PSI) was superior to many of the risk scores developed during the pandemic, for example, the International Severe Acute Respiratory Infection Consortium Coronavirus Clinical Characterisation Consortium (ISARIC 4C) (AUC 0.845 vs. 0.687, p < 0.001), and to many of the risk scores already in use, for example, the National Early Warning Score 2 (NEWS2) (AUC 0.845 vs. 0.589, p < 0.001). Furthermore, our study found that the Pneumonia Severity Index had a similar performance to other risk scores, such as CRB-65 (AUC 0.845 vs. 0.823, p = 0.294). Combining the PaO2/FiO2 or SpO2/FiO2 ratios with the risk scores analyzed improved the prognostic accuracy. Conclusions: Adding the SpO2/FiO2 ratio to the traditional, validated, and already internationally known pre-pandemic prognostic scores seems to be a valid and rapid alternative to the need for developing new prognostic scores. Future research should focus on integrating these markers into existing pneumonia scores to improve their prognostic accuracy.

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Identification of High Death Risk Coronavirus Disease-19 Patients using Blood Tests

Cited by 3 publications

References 53 publications

Predictors of Mortality in Hospitalized Patients with COVID-19: A One-Year Case-Control Study

Predictors of Mortality in Hospitalized Patients with COVID-19: A One-Year Case-Control Study

SpO2/FiO2 ratio. A promising index in predicting mortality in COVID-19 patients

The SpO2/FiO2 Ratio Combined with Prognostic Scores for Pneumonia and COVID-19 Increases Their Accuracy in Predicting Mortality of COVID-19 Patients

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