Risk factors for mortality in critically ill patients with COVID‐19 in Huanggang, China: A single‐center multivariate pattern analysis

2021

BMC Infect Dis

Background To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia. Methods A total of 156 patients diagnosed with COVID-19 pneumonia at the Central Hospital of Wuhan from January 29, 2020, to March 20, 2020, and 20 healthy individuals were enrolled in this single-centered retrospective study. The epidemiological parameters, clinical presentations, underlying diseases, laboratory test results, and disease outcomes were collected and analyzed. Results The median age of all enrolled patients was 66 years. At least one underlying disease was identified in 101 COVID-19 patients, with hypertension being the most common one, followed by cardiovascular disease and diabetes. The most common symptoms identified upon admission were fever, cough, dyspnea, and fatigue. Compared to survival cases, patients who died during hospitalization had higher plasma levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate, and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received antibiotics and anti-viral treatment. In addition, 60 patients received corticosteroids, and 51 received intravenous immunoglobulin infusion. Forty-four patients received noninvasive ventilation and 19 received invasive ventilation. Respiratory failure was the most frequently observed complication (106 [67.9%]), followed by sepsis (103 [66.0%]), acute respiratory distress syndrome (ARDS) (67 [42.9%]), and septic shock (50 [32.1%]). Multivariable regression suggested that advanced age (OR [odds ratio] = 1.098, 95% CI [confidence interval]: 1.006–1.199, P = 0.037), shorter duration from onset to admission (OR = 0.853, 95% CI: 0.750–0.969, P = 0.015) and elevated lactate level upon admission (OR = 2.689, 95% CI: 1.044–6.926, P = 0.040) were independent risk factors for in-hospital mortality for COVID-19 infection. Meanwhile, increased LYM (%) at admission (OR = 0.787, 95% CI: 0.686–0.903, P = 0.001) indicated a better prognosis. Conclusions In this study, we discovered that age, duration from onset to admission, LYM (%), and lactate level upon admission were independent factors that affecting the in-hospital mortality rate.

Section: Discussioncontrasting

confidence: 68%

Identification of risk factors for in-hospital death of COVID - 19 pneumonia -- lessions from the early outbreak

2021

BMC Infect Dis

“…The shorter duration from disease onset to admission was an important factor highly related to odds for death in con rmed cases of COVID-19, which was contrary to previous studies [21,22]. This might due to the lack of understanding of this disease in the early pandemic when a large portion of patients who had mild or moderate illness refused to seek proper medical treatment.…”

Section: Discussioncontrasting

confidence: 71%

Identification of risk factors for in-hospital death of COVID - 19 pneumonia -- lessions from the early outbreak

2020

Preprint

Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia at the Central Hospital of Wuhan from January 29, 2020, to March 20, 2020, and 20 healthy individuals were enrolled in this single-centered retrospective study. The epidemiological parameters, clinical presentations, underlying diseases, laboratory test results, and disease outcomes were collected and analyzed.Results: The median age of all enrolled patients was 66 years. At least one underlying disease was identified in 101 COVID-19 patients, with hypertension being the most common one, followed by cardiovascular disease and diabetes. The most common symptoms identified upon admission were fever, cough, dyspnea, and fatigue. Compared to survival cases, patients who died during hospitalization had higher plasma levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate, and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received antibiotics and anti-viral treatment. In addition, 60 patients received corticosteroids, and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation and 19 received invasive ventilation. Respiratory failure was the most frequently observed complication (106 [67.9%]), followed by sepsis (103 [66.0%]), acute respiratory distress syndrome (ARDS) (67 [42.9%]), and septic shock (50 [32.1%]).Multivariable regression suggested that advanced age (OR [odds ratio]=1.098, 95% CI [confidence interval]: 1.006-1.199, P=0.037), shorter duration from onset to admission (OR= 0.853, 95% CI: 0.750-0.969, P=0.015) and elevated lactate level upon admission (OR= 2.689, 95% CI: 1.044-6.926, P=0.040) were independent risk factors for in-hospital mortality for COVID-19 infection. Meanwhile, increased LYM (%) at admission (OR= 0.787, 95% CI: 0.686-0.903, P=0.001) indicated a better prognosis.Conclusions: In this study, we discovered that age, duration from onset to admission, LYM (%), and lactate level upon admission were independent factors that affecting the in-hospital mortality rate.

“…The shorter duration from disease onset to admission was an important factor highly related to odds for death in con rmed cases of COVID-19, which was contrary with previous studies [21,22]. This might due to the lack of understand of this disease in the early pandemic when a large portion of patients who had mild or moderate illness refused to seek proper medical treatment.…”

Section: Discussioncontrasting

confidence: 69%

Identification of risk factors for in-hospital death of COVID - 19 pneumonia -- lessions from the early outbreak

2020

Preprint

Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 and 20 healthy individuals were enrolled in this single-centered retrospective study. The epidemiological parameters, clinical presentations, underlying diseases, laboratory test results and disease outcomes were collected and analyzed. Results: The median age of all enrolled patients was 66 years. At least one underlying disease was identified in 101 COVID-19 patients, with hypertension being the most common one, followed by cardiovascular disease and diabetes. The most common symptoms identified upon admission were fever, cough, dyspnea and fatigue. Compared to survival cases, patients who dead during hospitalization had higher plasma levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation and 19 received invasive ventilation. Respiratory failure was the most frequently observed complication (106 [67.9%]), followed by sepsis (103 [66.0%]), acute respiratory distress syndrome (ARDS) (67 [42.9%]) and septic shock (50 [32.1%]). Multivariable regression suggested that advanced age (OR [odds ratio]=1.098, 95% CI [confidence interval]: 1.006-1.199, P=0.037), shorter duration from onset to admission (OR= 0.853, 95% CI: 0.750-0.969, P=0.015) and elevated lactate level upon admission (OR= 2.689, 95% CI: 1.044-6.926, P=0.040) were independent risk factors for in-hospital mortality for COVID-19 infection. Meanwhile, increased LYM (%) at admission (OR= 0.787, 95% CI: 0.686-0.903, P=0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age, duration from onset to admission, LYM (%) and lactate level upon admission were independent factors that affecting in-hospital mortality rate.