Prediction of mortality in hospitalized Egyptian patients with Coronavirus disease-2019: A multicenter retrospective study

Abstract

We aimed to assess the epidemiological, clinical, and laboratory characteristics associated with mortality among hospitalized Egyptian patients with COVID-19. A multicenter, retrospective study was conducted on all polymerase chain reaction (PCR)-confirmed COVID-19 cases admitted through the period from April to July 2020. A generalized linear model was reconstructed with covariates based on predictor’s statistical significance and clinically relevance. The odds ratio (OR) was calculated by using stepwise logistic regression modeling. A total of 3712 hospitalized patients were included; of them, 900 deaths were recorded (24.2%). Compared to survived patients, non-survived patients were more likely to be older than 60 years (65.7%), males (53.6%) diabetic (37.6%), hypertensive (37.2%), and had chronic renal insufficiency (9%). Non-survived patients were less likely to receive azithromycin (p <0.001), anticoagulants (p <0.001), and steroids (p <0.001). We found that age ≥ 60 years old (OR = 2.82, 95% CI 2.05–3.86; p <0.0001), diabetes mellitus (OR = 1.58, 95% CI 1.14–2.19; p = 0.006), hypertension (OR = 1.69, 95% CI 1.22–2.36; p = 0.002), chronic renal insufficiency (OR = 3.15, 95% CI 1.84–5.38; p <0.0001), tachycardia (OR = 1.65, 95% CI 1.22–2.23; p <0.001), hypoxemia (OR = 5.69, 95% CI 4.05–7.98; p <0.0001), GCS <13 (OR 515.2, 95% CI 148.5–1786.9; p <0.0001), the use of therapeutic dose of anticoagulation (OR = 0.4, 95% CI 0.22–0.74, p = 0.003) and azithromycin (OR = 0.16, 95% CI 0.09–0.26; p <0.0001) were independent negative predictors of mortality. In conclusion, age >60 years, comorbidities, tachycardia, hypoxemia, and altered consciousness level are independent predictors of mortality among Egyptian hospitalized patients with COVID-19. On the other hand, the use of anticoagulants and azithromycin is associated with reduced mortality.

Risk Factors Associated with Mortality among Patients with COVID-19: Analysis of a Cohort of 1213 Patients in a Tertiary Healthcare Center

“…However, no significant association was found with mortality. Our findings contrast with those reported in other studies such as the one by Muhammad M AbdelGhaffar et al who reported an OR for T2D mortality of 1.58 (95% CI 1.14–2.19; p = 0.006 [ 17 ]. Lana pinto et al performed a meta-analysis where the pooled OR was 3.53 (95% CI; 1.48–8.39) [ 18 ], similar to the Zeng-Hong Wu et al OR of 1.75 (95% CI 1.31–2.36; p = 0.0002) [ 19 ].…”

“…CRP is an acute-phase protein synthesized in hepatocytes in response to IL-6; its concentrations are elevated in different inflammatory processes including infectious ones and are therefore useful in the diagnosis and analysis of the severity of the infectious process [ 28 , 29 ]. Elevated D-dimer concentrations, also associated with C-reactive protein levels, have been associated with a poor prognosis in patients with COVID-19 [ 17 ], an effect associated with hypoxia due to severe pneumonia and increased inflammatory response, conditions related to a state of hypercoagulability, resulting in disseminated intravascular coagulation and multiorgan failure [ 17 ].…”

Partial-Methylated HeyL Promoter Predicts the Severe Illness in Egyptian COVID-19 Patients

“…As known, aging was itself considered a disease and strongly associated with many comorbidities that contributed to severe illness related with COVID-19 [ 39 ]. Concurrently, we found that the mean age of and mortality rate in Egyptian COVID-19 patients were lower than that in many published data from Western countries [ 40 , 41 ]. Of course, high income, social insurance, and well-developed state medical care support programs have an implication in the high life expectancy in Western countries comparing to that in Arab countries [ 42 ].…”

COVID-19 mortality surveillance in Lebanon

“…Analysis of the collected data revealed that the COVID-19 mortality rate was higher in older adults, particularly men. Studies conducted by Abdel Ghaffar et al in Egypt 12 and by Al-Mudhaffer et al in Iraq 13 showed that male gender was associated with higher risk of mortality compared to female. They also found that older age and comorbidities were significant predictors of mortality among COVID-19 patients.…”