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Risk factors for death in 1859 subjects with COVID-19

Lei Chen1, Jianming Yu1, Wenjuan He1

  • 1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Leukemia
|June 18, 2020
PubMed

Insights

Older age, smoking, higher admission temperature, elevated neutrophil-to-lymphocyte ratio (NLR), prolonged activated partial thromboplastin (aPTT), and increased D-dimer and serum creatinine levels are associated with higher COVID-19 in-hospital mortality risk. Lower platelet counts also increase mortality risk.

Area of Science:

  • Medical research
  • Epidemiology
  • Clinical diagnostics

Background:

  • COVID-19 has caused significant mortality worldwide.
  • Identifying risk factors for in-hospital death is crucial for patient management.

Purpose of the Study:

  • To investigate various clinical covariates associated with the risk of in-hospital death among COVID-19 patients.
  • To identify predictive markers for mortality in COVID-19.

Main Methods:

  • A retrospective study of 1859 COVID-19 patients from seven centers in Wuhan.
  • Multi-variable Cox regression analysis was used to assess the association between admission covariates and in-hospital death.
  • Piecewise linear regression analysis was employed to examine the relationship between Log10 neutrophil-to-lymphocyte ratio (NLR) and mortality risk.

Main Results:

  • Older age (HR=1.04), smoking (HR=1.84), higher admission temperature (HR=1.32), elevated Log10 NLR (HR=3.30), prolonged activated partial thromboplastin (aPTT) (HR=1.04), increased Log10 D-dimer (HR=3.00), and higher Log10 serum creatinine (HR=4.55) were significantly associated with increased in-hospital death risk.
  • Decreased platelet count (HR=0.996) was also linked to higher mortality.
  • Log10 NLR between 0.4 and 1.0 showed a significant association with increased death risk.

Conclusions:

  • Several admission covariates, including demographic, clinical, and laboratory markers, are significantly associated with in-hospital mortality in COVID-19 patients.
  • NLR, D-dimer, and serum creatinine are potent predictors of mortality.
  • These findings can aid in risk stratification and clinical decision-making for COVID-19 patients.

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