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Ann Med Surg (Lond)
. 2020 Dec;60:308-313.
doi: 10.1016/j.amsu.2020.10.071. Epub 2020 Nov 4.
Factors associated with increased mortality in hospitalized COVID-19 patients
Chirag Shah 1 , Donna J Grando 1 , Rebecca A Rainess 1 , Lydia Ayad 1 , Emad Gobran 1 , Payam Benson 1 , Meika T Neblett 1 , Vinod Nookala 1
Affiliations
- PMID: 33169090
- PMCID: PMC7641593
- DOI: 10.1016/j.amsu.2020.10.071
Abstract
Background: The rapid spread of the coronavirus disease 2019 (COVID-19) epidemic has significantly impacted global health. So far, the evidence regarding the risk factors that predict the outcomes of COVID-19 patients is limited. In this study, we identified several risk factors that are associated with increased mortality in COVID-19 patients.
Methods: We performed a retrospective review of electronic medical records of the patients admitted with an initial diagnosis of COVID-19. We extracted several patient variables (including demographics, lab results, and pre-existing conditions) and examined for their association with increased mortality.
Results: Of the 487 people included in the study, 340 survived and 147 expired. Significant differences existed in demographics and underlying comorbidities between the two groups. A higher proportion of patients were age 65 and older (87.76% vs 53.24%, p < 0.001), and were predominantly male (63.27% vs 52.94%, p = 0.0351). Multivariate analysis showed five variables to be the predictors for mortality: age ≥65 [OR = 3.87, 95% CI (2.01, 7.46), p < 0.001], initial presentation with dyspnea [OR = 1.71, 95% CI (1.03, 2.82), p = 0.037], history of cardiomyopathy [OR = 3.33, 95% CI (1.07, 10.41), p < 0.038], positive initial chest imaging findings [OR = 2.24, CI (1.26, 3.97), p = 0.006], and acute kidney injury (AKI) [OR = 3.33 CI (2.10, 5.28), P < 0.001].
Conclusion: Identifying COVID-19 patients with these characteristics may help guide the management and improve mortality.
Keywords: Acute kidney injury; COVID-19; Cardiomyopathy; Mortality; Risk factors.