Zaid Imam1,2, Fadi Odish1,2, Inayat Gill1,2, Daniel S. O’Connor1,2, Justin Armstrong1,2, Aimen Vanood3, Oluwatoyin Ibironke3, Angy Hanna1,2, A. Ranski3, Alexandra Halalau4,1,3
1From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA
2Internal Medicine Residents, Beaumont Hospital, Royal Oak, MI, USA
3Oakland University William Beaumont School of Medicine, Rochester, MI, USA
4Department of Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
Tóm tắt
AbstractIntroductionHigher comorbidity and older age have been reported as correlates of poor outcomes in COVID‐19 patients worldwide; however, US data are scarce. We evaluated mortality predictors of COVID‐19 in a large cohort of hospitalized patients in the United States.DesignRetrospective, multicenter cohort of inpatients diagnosed with COVID‐19 by RT‐PCR from 1 March to 17 April 2020 was performed, and outcome data evaluated from 1 March to 17 April 2020. Measures included demographics, comorbidities, clinical presentation, laboratory values and imaging on admission. Primary outcome was mortality. Secondary outcomes included length of stay, time to death and development of acute kidney injury in the first 48‐h.ResultsThe 1305 patients were hospitalized during the evaluation period. Mean age was 61.0 ± 16.3, 53.8% were male and 66.1% African American. Mean BMI was 33.2 ± 8.8 kg m−2. Median Charlson Comorbidity Index (CCI) was 2 (1–4), and 72.6% of patients had at least one comorbidity, with hypertension (56.2%) and diabetes mellitus (30.1%) being the most prevalent. ACE‐I/ARB use and NSAIDs use were widely prevalent (43.3% and 35.7%, respectively). Mortality occurred in 200 (15.3%) of patients with median time of 10 (6–14) days. Age > 60 (aOR: 1.93, 95% CI: 1.26–2.94) and CCI > 3 (aOR: 2.71, 95% CI: 1.85–3.97) were independently associated with mortality by multivariate analyses. NSAIDs and ACE‐I/ARB use had no significant effects on renal failure in the first 48 h.ConclusionAdvanced age and an increasing number of comorbidities are independent predictors of in‐hospital mortality for COVID‐19 patients. NSAIDs and ACE‐I/ARB use prior to admission is not associated with renal failure or increased mortality.
