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Risk factors for severe disease in patients admitted with COVID-19 to a hospital in London, England: a retrospective

J W Goodall1, T A N Reed2, M Ardissino1

  • 1Department of Infection, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK.

Epidemiology and Infection
|October 13, 2020
PubMed

Insights

Severe COVID-19 outcomes in hospitalized patients are linked to age, respiratory issues, and specific blood markers like urea and lactate. These factors are crucial for predicting mortality risk in patients with coronavirus disease 2019.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic necessitated understanding severe disease risk factors in hospitalized patients.
  • Identifying predictors of mortality is crucial for clinical management and resource allocation.

Purpose of the Study:

  • To characterize independent associations between clinical outcomes and patient factors in hospitalized COVID-19 patients.
  • To identify demographic, comorbidity, laboratory, and bedside observation predictors of mortality.

Main Methods:

  • Retrospective observational cohort study of 981 patients admitted with COVID-19.
  • Cox proportional hazards modeling used to explore associations with mortality.
  • Data collected included demographics, comorbidities, blood tests, and bedside observations.

Main Results:

  • The overall mortality rate was 36.0%.
  • Factors significantly associated with mortality included advanced age, respiratory disease, immunosuppression, elevated respiratory rate, hypoxia, low Glasgow Coma Scale score, high urea and alkaline phosphatase levels, elevated C-reactive protein, high lactate, and chest radiograph infiltrates.
  • A lower platelet count was associated with reduced mortality.

Conclusions:

  • Several clinical, laboratory, and radiological factors are independently associated with mortality in hospitalized COVID-19 patients.
  • These findings can aid in clinical risk stratification for coronavirus disease 2019.
  • Further research can be directed by these identified risk factors.

Keywords:
COVID-19hospitalisationsevere disease

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