Related Experiment Video
Updated: Nov 11, 2025
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Clinical Features and Risk Factors for In-Hospital Mortality From COVID-19 Infection at a Tertiary Care Medical
Ashish Bhargava1, Susanna M Szpunar1, Mamta Sharma1
1Division of Infectious Diseases, Department of Internal Medicine, Thomas Mackey Center for Infectious Disease Research, 21928Ascension St. John Hospital, Detroit, MI, USA.
Insights
Older age, higher comorbidity scores, and specific laboratory markers like low white blood cell counts and albumin predict COVID-19 mortality. Identifying these risk factors aids early interventions for severe cases.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- COVID-19 mortality is linked to advanced age, race, and comorbidities.
- Understanding clinical risk factors and biomarkers is crucial for early intervention.
- This study investigated in-hospital mortality risk factors in COVID-19 patients at a Detroit tertiary care center.
Purpose of the Study:
- To identify clinical risk factors and laboratory biomarkers associated with severe COVID-19 outcomes.
- To determine predictors of in-hospital mortality among COVID-19 patients.
- To inform early intervention strategies for high-risk individuals.
Main Methods:
- Retrospective cohort study of 565 adult inpatients with confirmed COVID-19.
- Data collected included comorbidities (Charlson Weighted Index of Comorbidity - CWIC), vital signs, and admission laboratory markers.
- Primary outcome was in-hospital mortality.
Main Results:
- The case fatality rate was 30.4% (172 deaths).
- Deceased patients were significantly older and had higher rates of congestive heart failure, dementia, hemiplegia, and malignancy.
- Multivariable analysis identified age >60, higher CWIC score, qSOFA, elevated WBC, lymphocytopenia, thrombocytopenia, low albumin, and high AST as mortality predictors.
Conclusions:
- This study identified key risk factors for COVID-19 in-hospital mortality during the early pandemic.
- After adjustment, the quick SOFA (qSOFA) score remained an independent predictor of mortality.
- Knowledge of these risk factors can guide patient observation and early therapeutic interventions.
Background:
Mortality from COVID-19 has been associated with older age, black race, and comorbidities including obesity, Understanding the clinical risk factors and laboratory biomarkers associated with severe and fatal COVID-19 will allow early interventions to help mitigate adverse outcomes. Our study identified risk factors for in-hospital mortality among patients with COVID-19 infection at a tertiary care center, in Detroit, Michigan.
Methods:
We conducted a single-center, retrospective cohort study at a 776-bed tertiary care urban academic medical center. Adult inpatients with confirmed COVID-19 (nasopharyngeal swab testing positive by real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay) from March 8, 2020, to June 14, 2020, were included. Clinical information including the presence of comorbid conditions (according to the Charlson Weighted Index of Comorbidity (CWIC)), initial vital signs, admission laboratory markers and management data were collected. The primary outcome was in-hospital mortality.
Results:
Among 565 hospitalized patients, 172 patients died for a case fatality rate of 30.4%. The mean (SD) age of the cohort was 64.4 (16.2) years, and 294 (52.0%) were male. The patients who died were significantly older (mean [SD] age, 70.4 [14.1] years vs 61.7 [16.1] years; P < 0.0001), more likely to have congestive heart failure (35 [20.3%] vs 47 [12.0%]; P = 0.009), dementia (47 [27.3%] vs 48 [12.2%]; P < 0.0001), hemiplegia (18 [10.5%] vs 18 [4.8%]; P = 0.01) and a diagnosis of malignancy (16 [9.3%] vs 18 [4.6%]; P = 0.03).From multivariable analysis, factors associated with an increased odds of death were age greater than 60 years (OR = 2.2, P = 0.003), CWIC score (OR = 1.1, P = 0.023), qSOFA (OR = 1.7, P < 0.0001), WBC counts (OR = 1.1, P = 0.002), lymphocytopenia (OR = 2.0, P = 0.003), thrombocytopenia (OR = 1.9, P = 0.019), albumin (OR = 0.6, P = 0.014), and AST levels (OR = 2.0, P = 0.004) on admission.
Conclusions:
This study identified risk factor for in-hospital mortality among patients admitted with COVID-19 in a tertiary care hospital at the onset of U.S. Covid-19 pandemic. After adjusting for age, CWIC score, and laboratory data, qSOFA remained an independent predictor of mortality. Knowing these risk factors may help identify patients who would benefit from close observations and early interventions.
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:29Pulmonary Embolism I: Introduction
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...