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Am J Emerg Med . Early predictors of mortality for moderate to severely ill patients with Covid-19

tetano

Editor, Senior Moderator
Am J Emerg Med


. 2020 Aug 28;S0735-6757(20)30770-1.
doi: 10.1016/j.ajem.2020.08.076. Online ahead of print.
Early predictors of mortality for moderate to severely ill patients with Covid-19


G?khan Aksel[SUP] 1 [/SUP], Mehmet Muzaffer İslam[SUP] 2 [/SUP], Abdullah Algın[SUP] 2 [/SUP], Serkan Emre Eroğlu[SUP] 2 [/SUP], G?kselin Beleli Yaşar[SUP] 2 [/SUP], Enis Ademoğlu[SUP] 2 [/SUP], ?mit Can D?lek[SUP] 2 [/SUP]



Affiliations

Abstract

Background: Determining the factors affecting the mortality and clinical conditions of the patients with Covid-19 are indispensable needs in developing patient treatment algorithms. We aimed to determine the parameters that can predict the mortality of moderate to severely ill patients with laboratory confirmed Covid-19.
Methods: Moderate to severely ill, Covid-19 patients older than 18 years were included. Mild Covid-19 patients and the ones with negative polymerase chain reaction test results were excluded from the study. The primary outcome of the study was 30-day mortality rate and we aimed to determine the factors affecting mortality in moderate to severely ill Covid-19 patients.
Results: 168 patient results were analyzed. Median age of the patients was 59.5 (48.3 to 76) and 90 (53.6%) were male. According to multivariate regression analysis results, the presence of any comorbid disease (p = 0.027, HR = 26.11 (95%CI: 1.45 to 471.31)), elevated C-reactive protein levels (CRP) (p < 0.001, HR = 1.24 (95%CI: 1.11 to 1.38)) and presence of dyspnea (p = 0.026, HR = 4.26 ((95%CI: 1.19 to 15.28)) were found to significantly increase the mortality, while high pulse O 2 saturation level (p < 0.001, HR = 0.90 (95%CI: 0.82 to 0.99) was found to decrease. When receiver operating characteristic curve was created for laboratory tests, it was determined that white blood cell counts, neutrophil counts, CRP levels and neutrophil/lymphocyte ratio predicted mortality while Lymphocyte levels did not.
Conclusion: Dyspnea, the presence of any comorbid disease, elevated CRP levels, and low pulse O 2 saturation levels predict mortality in moderate to severely ill Covid-19 patients.

Keywords: 2019 novel coronavirus disease; COVID-19 pandemic; Mortality; SARS-CoV-2 infection.
 
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