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BMC Infect Dis . Assessment of COVID-19 risk factors of early and long-term mortality with prediction models of clinical and laboratory variables

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2024 Jul 9;24(1):685.
doi: 10.1186/s12879-024-09592-7. Assessment of COVID-19 risk factors of early and long-term mortality with prediction models of clinical and laboratory variables

Dawid Lipski[SUP] 1 [/SUP], Artur Radziemski[SUP] 2 [/SUP], Stanisław Wasiliew[SUP] 2 [/SUP], Michał Wyrwa[SUP] 2 [/SUP], Ludwina Szczepaniak-Chicheł[SUP] 2 [/SUP], Łukasz Stryczyński[SUP] 2 [/SUP], Anna Olasińska-Wiśniewska[SUP] 3 [/SUP], Tomasz Urbanowicz[SUP] 3 [/SUP], Bartłomiej Perek[SUP] 3 [/SUP], Andrzej Tykarski[SUP] 2 [/SUP], Anna Komosa[SUP] 2 [/SUP]



Affiliations
Abstract

Background: Coronavirus disease (COVID-19) may lead to serious complications and increased mortality. The outcomes of patients who survive the early disease period are burdened with persistent long-term symptoms and increased long-term morbidity and mortality. The aim of our study was to determine which baseline parameters may provide the best prediction of early and long-term outcomes.
Methods: The study group comprised 141 patients hospitalized for COVID-19. Demographic data, clinical data and laboratory parameters were collected. The main study endpoints were defined as in-hospital mortality and 1-year mortality. The associations between the baseline data and the study endpoints were evaluated. Prediction models were created.
Results: The in-hospital mortality rate was 20.5% (n = 29). Compared with survivors, nonsurvivors were significantly older (p = 0.001) and presented comorbidities, including diabetes (0.027) and atrial fibrillation (p = 0.006). Assessment of baseline laboratory markers and time to early death revealed negative correlations between time to early death and higher IL-6 levels (p = 0.032; Spearman rho - 0.398) and lower lymphocyte counts (p = 0.018; Pearson r -0.438). The one-year mortality rate was 35.5% (n = 50). The 1-year nonsurvivor subgroup was older (p < 0.001) and had more patients with arterial hypertension (p = 0.009), diabetes (p = 0.023), atrial fibrillation (p = 0.046) and active malignancy (p = 0.024) than did the survivor subgroup. The model composed of diabetes and atrial fibrillation and IL-6 with lymphocyte count revealed the highest value for 1-year mortality risk prediction.
Conclusions: Diabetes and atrial fibrillation, as clinical factors, and LDH, IL-6 and lymphocyte count, as laboratory determinants, are the best predictors of COVID-19 mortality risk.

Keywords: COVID-19; Inflammation; LDH; Pneumonia.

 
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