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Published on: September 20, 2024
Inflammation-associated factors for predicting in-hospital mortality in patients with COVID-19
Jun-Hong Wang1, Ru-Dong Chen1, Hong-Kuan Yang1
1Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Insights
Inflammation markers like C-reactive protein and interleukin-6, along with neutrophil count, are key predictors of in-hospital death in coronavirus disease-2019 patients. Early identification of these factors aids in risk stratification and patient management.
Area of Science:
- Medical Research
- Clinical Medicine
- Inflammation Biology
Background:
- Coronavirus disease-2019 (COVID-19) poses a significant threat, with in-hospital mortality being a critical outcome.
- Understanding the predictors of mortality is crucial for effective patient management and resource allocation.
Purpose of the Study:
- To investigate the association between inflammation-associated factors and in-hospital mortality in COVID-19 patients.
- To identify independent predictors of in-hospital death among hospitalized COVID-19 patients.
Main Methods:
- Utilized univariate Cox regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression for variable selection.
- Employed multivariate Cox regression analysis to determine independent risk factors for mortality.
- Analyzed clinical characteristics and laboratory parameters of 1135 hospitalized COVID-19 patients.
Main Results:
- Six independent risk factors for in-hospital mortality were identified: myoglobin, C-reactive protein, neutrophil count, interleukin-6 (IL-6), age, and international normalized ratio.
- C-reactive protein, neutrophil count, and IL-6 demonstrated significant independent predictive ability for in-hospital mortality.
- Myoglobin, age, and international normalized ratio also emerged as significant predictors.
Conclusions:
- Inflammation-associated factors are significantly linked to in-hospital mortality in COVID-19 patients.
- C-reactive protein, neutrophil count, and IL-6 are robust independent predictors of mortality.
- These findings facilitate early identification of high-risk patients and inform clinical management strategies.
Abstract:
The aim is to explore the relation between inflammation-associated factors and in-hospital mortality and investigate which factor is an independent predictor of in-hospital death in patients with coronavirus disease-2019. This study included patients with coronavirus disease-2019, who were hospitalized between February 9, 2020, and March 30, 2020. Univariate Cox regression analysis and least absolute shrinkage and selection operator regression (LASSO) were used to select variables. Multivariate Cox regression analysis was applied to identify independent risk factors in coronavirus disease-2019. A total of 1135 patients were analyzed during the study period. A total of 35 variables were considered to be risk factors after the univariate regression analysis of the clinical characteristics and laboratory parameters (p < .05), and LASSO regression analysis screened out seven risk factors for further study. The six independent risk factors revealed by multivariate Cox regression were myoglobin (HR, 5.353; 95% CI, 2.633-10.882; p < .001), C-reactive protein (HR, 2.063; 95% CI, 1.036-4.109; p = .039), neutrophil count (HR, 2.015; 95% CI, 1.154-3.518; p = .014), interleukin 6 (Il-6; HR, 9.753; 95% CI, 2.952-32.218; p < .001), age (HR, 2.016; 95% CI, 1.077-3.773; p = .028), and international normalized ratio (HR, 2.595; 95% CI, 1.412-4.769; p = .002). Our results suggested that inflammation-associated factors were significantly associated with in-hospital mortality in coronavirus disease-2019 patients. C-reactive protein, neutrophil count, and interleukin 6 were independent factors for predicting in-hospital mortality and had a better independent predictive ability. We believe these findings may allow early identification of the patients at high risk for death, and can also assist in better management of these patients.
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