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Predictors of mortality in 217 COVID-19 patients in Northwest Ohio, United States: A retrospective study
Ganesh Prasad Merugu1, Zeid Nesheiwat2, Mamtha Balla3
1Division of Geriatric Medicine, Department of Family Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA.
Insights
Low hemoglobin, elevated INR, low platelets, and high procalcitonin levels predict higher COVID-19 mortality. Treatments like antibiotics and intubation, along with complications such as ARDS, also indicate increased risk in patients with coronavirus disease 2019.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Clinical Pathology
Background:
- The COVID-19 pandemic presents a significant global health challenge with high morbidity and mortality.
- Identifying predictors of mortality is crucial for effective patient management and resource allocation.
Purpose of the Study:
- To identify specific laboratory markers, complications, and treatments associated with increased mortality in COVID-19 patients.
- To provide healthcare professionals with key indicators for predicting adverse outcomes in coronavirus disease 2019.
Main Methods:
- Retrospective study of 217 COVID-19 positive patients admitted to a US hospital.
- Analysis of laboratory values, complications, and treatments using T-tests and chi-squared analyses.
- COVID-19 confirmation via polymerase chain reaction.
Main Results:
- Mortality was associated with low hemoglobin, elevated INR, low platelets, and elevated procalcitonin (p < 0.05).
- Marginally significant predictors included elevated troponin and creatinine.
- Treatments (antibiotics, antifungals, antivirals, blood transfusion, steroids, intubation) and complications (ARDS, myocarditis, elevated INR, septic shock, age > 63) were significant predictors of mortality.
Conclusions:
- Low hemoglobin, elevated INR, low platelets, and elevated procalcitonin are key laboratory predictors of COVID-19 mortality.
- Specific treatments and complications significantly increase the risk of death in coronavirus disease 2019 patients.
- Awareness of these predictors is essential for healthcare professionals managing COVID-19.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic continues to cause significant morbidity and mortality worldwide. This study aims to identify specific lab markers, complications, and treatments that may be associated with increased mortality in COVID-19 patients. This study is retrospective in nature; it included 217 COVID-19 positive patients who were admitted to a ProMedica Health System hospital in Northwest Ohio, United States, between March 25 and June 16, 2020. We collected various laboratory values, complications, and treatment courses. T test and χ2 analyses were used to predict mortality. COVID-19 test was confirmed via polymerase chain reaction. Of 217 patients included in the study, the mean age of the population was 63.13 (SD, 17.8), of which 194 (89.4%, mean age 61.7 years) survived while 23 (10.6%, mean age 74.6 years) died. Among them, 53% were females and 47% male. Laboratory values that were associated with mortality were low hemoglobin (p = .0046), elevated INR (p = .0005), low platelets (p = .0246) and elevated procalcitonin (p = .0472). Marginally significant laboratory values included elevated troponin (p = .0661), and elevated creatinine (p = .0741). Treatment with either antibiotic, antifungals, antivirals, blood transfusion, steroids, and intubation were all statistically significant for mortality. COVID-19 related complications with either ARDS, myocarditis, elevated INR, septic shock, or age greater than 63 were significant predictors of mortality. Low hemoglobin, elevated INR, Low platelet, elevated procalcitonin, treated with either antibiotic, antifungal, antiviral, blood transfusion, steroids, and intubation are associated with high mortality related to COVID-19 infection. Healthcare professionals must be aware of these predictors.
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