Factors associated with adverse outcome among hospitalized patients with moderate to severe COVID-19

S. Mishinova, Y. Gomon, A. Kolbin, E. V. Verbitskaya, T. I. Galimov
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Abstract

Aims. To consider factors associated with adverse outcome among hospitalized patients with moderate and severe COVID-19.Materials and methods. Data from 345 case histories of adult patients hospitalized with moderate to severe COVID-19 were analyzed in a single-center retrospective study. Characteristics by sex, age, number of days from disease onset to admission to hospital, duration of hospitalization, duration of disease, population characteristics by medical history of comorbidities and self-medication, outcome of hospitalization and medical technologies used in hospital conditions were given for the whole cohort of patients. All parameters were analyzed using descriptive statistics methods. Qualitative variables are given in absolute (n) and relative (%) values with 95% confidence interval. Continuous variables were presented as median and quartiles. Risk factors for mortality were determined across groups using the χ2  criterion and odds ratio.Results. There was no demonstrated effect of gender, degree of pulmonary tissue lesions on computed tomography data, or time of initiation of respiratory support on disease outcome. At the same time, the age older than 65 years as well as neoplasms, type 2 diabetes mellitus, dementia, Stage 3 arterial hypertension, chronic heart failure, coronary heart disease, myocardial infarction and stroke history, chronic obstructive pulmonary disease, bronchiectatic disease, urogenital diseases were the predictors of unfavorable outcome in patients with moderate and severe COVID-19 form. Prehospital use of antiplatelet agents, direct and indirect oral anticoagulants, drugs affecting the renin-angiotensin system, systemic glucocorticosteroids, antibiotics, antiviral drugs, and analgesics was associated with a decrease in the mortality rate in patients with moderate-to-severe COVID-19, as well as timely use of pronposition and transfer to intensive care unit.Conclusions. Our findings are partially consistent with previous reports on the effect of risk factors on COVID-19 outcomes.
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中重度COVID-19住院患者不良结局相关因素
目标探讨中重度COVID-19住院患者不良结局的相关因素。材料和方法。采用单中心回顾性研究方法,分析了345例成人中重度COVID-19住院患者的病史。给出了整个队列患者的性别、年龄、发病至入院天数、住院时间、疾病持续时间、合并症病史和自我用药的人群特征、住院结果和医院条件下使用的医疗技术。所有参数采用描述性统计方法进行分析。定性变量以绝对值(n)和相对值(%)给出,置信区间为95%。连续变量以中位数和四分位数表示。采用χ2标准和优势比确定各组死亡率的危险因素。没有证据表明性别、肺组织病变程度对计算机断层扫描数据的影响,或开始呼吸支持的时间对疾病结局的影响。同时,年龄大于65岁,肿瘤、2型糖尿病、痴呆、3期动脉高血压、慢性心力衰竭、冠心病、心肌梗死及脑卒中史、慢性阻塞性肺疾病、支气管扩张性疾病、泌尿生殖系统疾病是中重度COVID-19患者预后不良的预测因素。院前使用抗血小板药物、直接和间接口服抗凝剂、影响肾素-血管紧张素系统的药物、全身性糖皮质激素、抗生素、抗病毒药物和镇痛药物与中重度COVID-19患者死亡率下降有关,并及时使用建议和转入重症监护病房。我们的发现与之前关于风险因素对COVID-19结局影响的报告部分一致。
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