tetano
Editor, Senior Moderator
J Epidemiol
. 2022 Nov 12.
doi: 10.2188/jea.JE20220201. Online ahead of print.
Mortality-Associated Risk Factors in Hospitalized COVID-19 Patients in Japan: Findings of the CLOT-COVID Study
Makoto Takeyama[SUP] 1 [/SUP], Sen Yachi[SUP] 1 [/SUP], Yuji Nishimoto[SUP] 2 [/SUP], Ichizo Tsujino[SUP] 3 [/SUP], Junichi Nakamura[SUP] 3 [/SUP], Naoto Yamamoto[SUP] 4 [/SUP], Hiroko Nakata[SUP] 5 [/SUP], Satoshi Ikeda[SUP] 6 [/SUP], Michihisa Umetsu[SUP] 7 [/SUP], Shizu Aikawa[SUP] 8 [/SUP], Hiroya Hayashi[SUP] 9 [/SUP], Hirono Satokawa[SUP] 10 [/SUP], Yoshinori Okuno[SUP] 11 [/SUP], Eriko Iwata[SUP] 12 [/SUP], Yoshito Ogihara[SUP] 13 [/SUP], Nobutaka Ikeda[SUP] 14 [/SUP], Akane Kondo[SUP] 15 [/SUP], Takehisa Iwai[SUP] 16 [/SUP], Norikazu Yamada[SUP] 17 [/SUP], Tomohiro Ogawa[SUP] 18 [/SUP], Takao Kobayashi[SUP] 4 [/SUP], Makoto Mo[SUP] 19 [/SUP], Yugo Yamashita[SUP] 11 [/SUP]
Affiliations
Abstract
Background: Reports of mortality-associated risk factors in patients with coronavirus disease (COVID-19) are limited.
Methods: We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (N=158) and those who were alive at discharge (N=2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study.
Results: Patients who died were older (71.1 years versus 51.6 years, P<0.001), had higher median D-dimer values on admission (1.7 μg/mL versus 0.8 μg/mL, P<0.001), and had more comorbidities. On admission, the patients who died had more severe COVID-19 than did those who survived (mild: 16% versus 63%, moderate: 47% versus 31%, and severe: 37% versus 6.2%, P<0.001). In patients who died, the incidence of thrombosis and major bleeding during hospitalization was significantly higher than that in those who survived (thrombosis: 8.2% vs. 1.5%, P<0.001; major bleeding: 12.7% vs. 1.4%, P<0.001). Multivariable logistic regression analysis revealed that age >70 years, high D-dimer values on admission, heart disease, active cancer, higher COVID-19 severity on admission, and development of major bleeding during hospitalization were independently associated with a higher mortality risk.
Conclusions: This large-scale observational study in Japan identified several independent risk factors for mortality in hospitalized patients with COVID-19 that could facilitate appropriate risk stratification of patients with COVID-19.
Keywords: COVID-19; Mortality; Risk factors; Thrombosis.
. 2022 Nov 12.
doi: 10.2188/jea.JE20220201. Online ahead of print.
Mortality-Associated Risk Factors in Hospitalized COVID-19 Patients in Japan: Findings of the CLOT-COVID Study
Makoto Takeyama[SUP] 1 [/SUP], Sen Yachi[SUP] 1 [/SUP], Yuji Nishimoto[SUP] 2 [/SUP], Ichizo Tsujino[SUP] 3 [/SUP], Junichi Nakamura[SUP] 3 [/SUP], Naoto Yamamoto[SUP] 4 [/SUP], Hiroko Nakata[SUP] 5 [/SUP], Satoshi Ikeda[SUP] 6 [/SUP], Michihisa Umetsu[SUP] 7 [/SUP], Shizu Aikawa[SUP] 8 [/SUP], Hiroya Hayashi[SUP] 9 [/SUP], Hirono Satokawa[SUP] 10 [/SUP], Yoshinori Okuno[SUP] 11 [/SUP], Eriko Iwata[SUP] 12 [/SUP], Yoshito Ogihara[SUP] 13 [/SUP], Nobutaka Ikeda[SUP] 14 [/SUP], Akane Kondo[SUP] 15 [/SUP], Takehisa Iwai[SUP] 16 [/SUP], Norikazu Yamada[SUP] 17 [/SUP], Tomohiro Ogawa[SUP] 18 [/SUP], Takao Kobayashi[SUP] 4 [/SUP], Makoto Mo[SUP] 19 [/SUP], Yugo Yamashita[SUP] 11 [/SUP]
Affiliations
- PMID: 36372435
- DOI: 10.2188/jea.JE20220201
Abstract
Background: Reports of mortality-associated risk factors in patients with coronavirus disease (COVID-19) are limited.
Methods: We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (N=158) and those who were alive at discharge (N=2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study.
Results: Patients who died were older (71.1 years versus 51.6 years, P<0.001), had higher median D-dimer values on admission (1.7 μg/mL versus 0.8 μg/mL, P<0.001), and had more comorbidities. On admission, the patients who died had more severe COVID-19 than did those who survived (mild: 16% versus 63%, moderate: 47% versus 31%, and severe: 37% versus 6.2%, P<0.001). In patients who died, the incidence of thrombosis and major bleeding during hospitalization was significantly higher than that in those who survived (thrombosis: 8.2% vs. 1.5%, P<0.001; major bleeding: 12.7% vs. 1.4%, P<0.001). Multivariable logistic regression analysis revealed that age >70 years, high D-dimer values on admission, heart disease, active cancer, higher COVID-19 severity on admission, and development of major bleeding during hospitalization were independently associated with a higher mortality risk.
Conclusions: This large-scale observational study in Japan identified several independent risk factors for mortality in hospitalized patients with COVID-19 that could facilitate appropriate risk stratification of patients with COVID-19.
Keywords: COVID-19; Mortality; Risk factors; Thrombosis.