Predictors of severity and mortality in COVID-19 patients

Springer Science and Business Media LLC - 2022
Hebatallah Hany Assal1, Hoda M. Abdel-Hamid1, Sally Magdy1, Maged Salah2, Asmaa Ali3, Rasha Helmy Elkaffas4, Irene M. Sabry1
1Department of Chest Medicine, Faculty of Medicine, Cairo University, Al Kasr Al Aini, Old Cairo, Cairo, 11956, Egypt
2Department of Anaethesia, Faculty of Medicine, Cairo University, Cairo, Egypt
3Department of Chest, Abbassia Chest Hospital, Ministry of Health and Population (MOHP), Cairo, Egypt
4Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt

Tóm tắt

Abstract Background Due to limited capacity, health care systems worldwide have been put in challenging situations since the emergence of COVID-19. To prioritize patients who need hospital admission, a better understanding of the clinical predictors of disease severity is required. In the current study, we investigated the predictors of mortality and severity of illness in COVID-19 from a single center in Cairo, Egypt. Methods This retrospective cohort study included 175 patients hospitalized with COVID-19 pneumonia and had positive real-time polymerase chain reaction (RT-PCR) results for SARS-CoV-2 from 1 May 2020 to 1 December 2020. Severe COVID-19 was defined as requiring high-flow oxygen (flow rate of more than 8 L/min or use of high flow oxygen cannula), noninvasive ventilation, or invasive mechanical ventilation at any time point during the hospitalization. We used univariate and multivariate regression analyses to examine the differences in patient demographics and clinical and laboratory data collected during the first 24 h of hospitalization related to severe disease or death in all 175 patients. Results Sixty-seven (38.3%) of the study subjects had a severe or critical disease. Elevated d-dimer, leukocytosis, and elevated CRP were found to be independent predictors of severe disease. In-hospital mortality occurred in 34 (19.4%) of the cases. Elevated TLC, urea, the use of invasive mechanical ventilation, and the presence of respiratory bacterial co-infection were found to be independently associated with mortality. Conclusion Clinical and laboratory data of COVID-19 patients at their hospital admission may aid clinicians in the early identification and triage of high-risk patients.

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