The laboratory and clinical factors associated with mortality in COVID-19 patients

Amin Izadi, M. Darban, Milad Khanzadeh Germi, Sourena Nabavi, M. A. Kouloubandi, Homa Dadras Toussi, Aysan Vaez, Malihe Ghazvini, M. Mirmohammadkhani
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引用次数: 1

Abstract

Background: In December 2019, the Chinese government declared the prevalence of a new epidemic belonging to the coronavirus family;later, this epidemic was called COVID-19. Objectives: To determine the clinical and laboratory factors involved in the mortality of hospitalized COVID-19 patients. Methods: This descriptive-analytic study was performed in Kowsar Hospital of Semnan, Iran, using medical files of 107 patients hospitalized during February-April 2020 with COVID-19 diagnosis with the presence of chest CT findings. The patients’ demographic information, vital signs, clinical symptoms, lab test results, the prescribed medicines during hospitalization, past medical history, and outcomes were analyzed. The relationship between each of the explanatory variables with death outcome was examined using univariate and multivariate logistic regression models, reporting crude and adjusted odds ratios (OR & Adj. OR). Results: The mean age of the patients was 63.36 ± 16.43 years, 67 (62.6%) patients were male, and 85 (79.4%) patients were discharged. Low level of consciousness (Glasgow coma scale < 14) (discharged: 8.2% vs. expired: 40.2%, Adj. OR [95% confidence interval] = 17.9 [3.1, 102.7]), higher body temperature (37.1°C vs. 37.74°C, 3.62 [1.55, 8.43]), and higher blood alkaline phosphatase (177.6 vs. 247.6, 1.01 [1.00, 1.01]) at the time of hospitalization were associated with increased mortality. Also, having the symptom of fatigue or weakness at the time of hospitalization (61.2 vs. 36.4%, 0.06 [0.01, 0.46]), higher red blood cells count (4.67 vs. 4.15, 0.21 [0.08, .55]), and higher blood oxygen saturation levels (89 vs. 82%, 0.92 [0.85, 0.99]) were associated with a lower risk of mortality. Conclusions: Decreased level of consciousness at the time of admission was shown to be a critical and independent predictor of mortality. Several factors are associated with death in patients with COVID-19, which due to the complexity of the relationship between each of them, it is not practical and plausible to make a definite prediction of patients’ prognosis only by noting few factors without considering all the clinical symptoms and laboratory findings. The results of individual studies like ours should be interpreted alongside the results of previous and future clinical studies and not alone. © 2021, Semnan University of Medical Sciences. All rights reserved.
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与新冠肺炎患者死亡率相关的实验室和临床因素
背景:2019年12月,中国政府宣布一种属于冠状病毒家族的新冠疫情流行;后来,这种流行病被称为新冠肺炎。目的:确定新冠肺炎住院患者死亡率的临床和实验室因素。方法:这项描述分析研究在伊朗塞姆南Kowsar医院进行,使用了2020年2月至4月期间107名诊断为新冠肺炎并有胸部CT表现的住院患者的医疗档案。分析患者的人口统计信息、生命体征、临床症状、实验室检测结果、住院期间的处方药、既往病史和结果。使用单变量和多变量逻辑回归模型检查每个解释变量与死亡结果之间的关系,报告粗略和调整后的比值比(OR&Adj.OR)。结果:患者平均年龄为63.36±16.43岁,男性67例(62.6%),出院85例(79.4%)。住院时意识水平低(格拉斯哥昏迷评分<14)(出院:8.2%对过期:40.2%,调整OR[95%置信区间]=17.9[3.102.7])、体温升高(37.1°C对37.74°C,3.62[1.55,8.43])和血液碱性磷酸酶升高(177.6对247.61.01[1.00,1.01])与死亡率增加有关。此外,住院时出现疲劳或虚弱症状(61.2 vs.36.4%,0.06[0.01,0.46])、红细胞计数较高(4.67 vs.4.15,0.21[0.08,.55])和血氧饱和度较高(89 vs.82%,0.92[0.85,0.99])与死亡率较低有关。结论:入院时意识水平下降是死亡率的一个重要且独立的预测因素。新冠肺炎患者的死亡与几个因素有关,由于每个因素之间关系的复杂性,仅通过注意几个因素而不考虑所有临床症状和实验室结果来对患者的预后做出明确预测是不切实际和不合理的。像我们这样的个别研究的结果应该与以前和未来的临床研究结果一起解释,而不是单独解释。©2021,塞姆南医学科学大学。保留所有权利。
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