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

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.