Mortality Predictors in Severe COVID-19 Patients from an East European Tertiary Center: A Never-Ending Challenge for a No Happy Ending Pandemic (original) (raw)
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Journal of Clinical Medicine
Background: We aimed to externally validate three prognostic scores for COVID-19: the 4C Mortality Score (4CM Score), the COVID-GRAM Critical Illness Risk Score (COVID-GRAM), and COVIDAnalytics. Methods: We evaluated the scores in a retrospective study on adult patients hospitalized with severe/critical COVID-19 (1 March 2020–1 March 2021), in the Teaching Hospital of Infectious Diseases, Cluj-Napoca, Romania. We assessed all the deceased patients matched with two survivors by age, gender, and at least two comorbidities. The areas under the receiver-operating characteristic curves (AUROCs) were computed for in-hospital mortality. Results: Among 780 severe/critical COVID-19 patients, 178 (22.8%) died. We included 474 patients according to the case definition (158 deceased/316 survivors). The median age was 75 years; diabetes mellitus, malignancies, chronic pulmonary diseases, and chronic kidney and moderate/severe liver diseases were associated with higher risks of death. According t...
Early predictors of mortality for moderate to severely ill patients with Covid-19
The American Journal of Emergency Medicine, 2021
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International Journal of General Medicine
Since the initial documentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late December 2019, the coronavirus disease 2019 (COVID-19) pandemic has become a leading cause of morbidity and mortality worldwide. Under these circumstances, the present study aimed to analyze the characteristics of hospitalized cases, according to the progression and severity of the disease, to reveal the main independent risk factors for death by COVID-19 in the western Romanian population. Patients and Methods: This retrospective study included 936 patients admitted to Victor Babes Clinical Hospital of Infectious Diseases Timisoara, with COVID-19 between 1 February 2020 and 31 January 2021. The patients were divided into three subsamples based on disease severity: subsample I (n = 344), comprising patients with mild forms of the disease; subsample II (n = 475) comprising patients with moderate disease; and subsample III (n = 117) for patients with severe disease. Biochemical analysis and assessment of disease severity were performed on all patients. Results: The mean age was 48.76 years (two months to 94 years). The median values for age, number of hospitalization days, and disease duration days before hospital admission varied with high statistical significance between the three subsamples (p < 0.001). A statistically significant difference was also observed regarding body mass index (BMI), with higher values in subsample III (p < 0.001). The in-hospital fatality rate was zero in subsample I, 3.58% in subsample II, and 71.79% in subsample III (p < 0.001). Of the deceased patients, 69.31% were over the age of 65 years, 29.70% were aged 36-64 years, and 0.99% were aged 19-35 years. Cumulated comorbidities were recorded in 92.08% of the deceased patients. Conclusion: Older age, the number of disease duration days before hospital admission, BMI, and renal pathology are independent risk factors for mortality in COVID-19 and can help clinicians to identify patients with poor prognosis and who are at high risk for mortality at an early stage.
The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
Respiratory Medicine, 2021
The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5-5.6). The univariate analysis demonstrated that various factors, including male sex, age ≥65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6-23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored.
Predictors of mortality related to Covid-19
World Journal of Advanced Research and Reviews, 2022
Introduction: The new 2019 coronavirus has spread rapidly around the world, creating a pandemic. Since the beginning of the pandemic, 6.012.035 patients have died. The objective of this study is to identify clinical and biological parameters associated with high mortality in patients with COVID-19 pneumonia. Material and methods: We report a retrospective study carried out in a Covid department of the Mohamed VI University Hospital of Marrakech between 20 October and 20 December 2021. Patients were divided into 2 groups: a survivor group and a decedent group. Results: We collected 103 cases during this period. A male predominance was noted in 55.3% of cases. The group of deceased included 9 cases (8.7%) while the group of survivors contained 94 cases (91.2%). The average age of the patients in the survivor group was 44.6 years, while it was higher in the deceased group (60.6 years). We noted that the deceased patients had more arterial hypertension (55.6% vs. 10.6%) and heart diseas...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Introduction: Coronavirus Disease in 2019 (COVID-19) is globally a major factor in the mortality of patients. Hence, there is an immediate requirement to recognise the mortality predictors in the COVID-19 patients. Aim: To identify the clinical features and risk factors for the mortality of adult patients suffering from COVID-19 in Sirjan, Iran. Materials and Methods: In this retrospective cohort study, all demographic, clinical, laboratory data of COVID-19 patients who were admitted to hospitals of Sirjan city was collected from July to October 2020 and data was analysed in November 2020. In this period, 269 patients with COVID-19 were admitted. The findings based on the considered parameters of patients in the hospital was recorded; Univariable and multivariable logistic regression methods were applied to find the risk factors due to in hospital death. Results: Out of 269 patients, 39 patients (14.5%) died in the hospital and the rest were discharged. A total of 152 (56.5%) patien...
Factors Associated with Death of Covid-19 Patients: Case Series
Serbian Journal of Experimental and Clinical Research
This aim of this study was to identify potential factors associated with survival in patients with coronavirus disease 2019 (COVID- 19). This study was designed as a case series. It included patients hospitalized in Clinical Centre Kragujevac between March 10, 2020, and June 15, 2020, due to COVID-19. Variables with significant influence on the cure of patients were identified by multivariate logistic regression. A total of 234 patients were included. The average age of the patients was 57.2 ± 15.8 years. Thirty-five patients died (15.0%) and 199 (85.0%) were discharged as completely cured and with the sustained virological response. The study variables with significant influence (expressed as odds ratio – OR) on cure of COVID-19 patients after adjustment for effects of other variables were: stay in an intensive care unit – ICU (OR = 0.007; 95% confidence interval – CI 0.001 – 0.086; p = 0.000), previous hospitalization (OR = 7.802; 95% CI 1.198 – 50.924; p = 0.032), increased body ...
Evaluation of mortality predictors in hospitalized COVID-19 patients: Retrospective cohort study
Tuberk Toraks
Evaluation of mortality predictors in hospitalized COVID-19 patients: Retrospective cohort study Introduction: Evaluation of parameters that will predict prognosis in COVID-19 disease ensures correct determination of treatment strategy. In this study, it was aimed to determine the clinical, radiological and laboratory parameters affecting mortality and to evaluate the risk factors. Materials and Methods: Patients hospitalized with the diagnosis of COVID-19 in September 2020 were included in the study. Clinical features, laboratory parameters, and radiological findings at admission were recorded. The relationship of these parameters with 30-day mortality was evaluated. Statistical analysis was performed with SPSS for Windows 16.0 Package Program. Results: Three hundred and sixty patients (female/male, n= 228/132) hospitalized in the specified period were included in the study. 30-day mortality rate was 14.4% in all patients. In multiple logistic regression analysis, age, presence of heart failure, admission oxygen saturation, body temperature higher than 38.2 and high ferritin levels were evaluated as independent risk factors for 30-day mortality. Conclusion: The relationship between clinical and laboratory markers and mortality is very important for the correct orientation of healthcare services and the correct determination of treatment strategy during the COVID-19 pandemic.
COVID-19 Mortality and Related Comorbidities in Hospitalized Patients in Bulgaria
Healthcare
Until now, the COVID-19 pandemic has resulted in at least 27 million cases and over 900,000 deaths worldwide. Bulgaria is one of the countries that is the most severely affected by the COVID-19 pandemic, and the mortality rate is among the highest registered in the world. The aim of this study is to investigate and analyze mortality rates due to the fact of COVID-19 in addition to the most common related underlying medical conditions in those hospitalized to outline the factors that have an impact on the mortality rate due to the fact of COVID-19. A descriptive cross-sectional research design with a retrospective analysis was used to collect data from a total of 128,269 hospitalized patients during the period from April 2020 to November 2021. During the study period, the number of hospital admissions due to the fact of COVID-19 was 5200. The patients’ mean age was 67.34 (SD ± 19.65), and 51.7% (2689) of the patients were men. Only 10% of out of a total of 5200 patients did not test ...