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Published on: September 8, 2023
Prognostic Factors in Hospitalized COVID-19 Patients at the Start of the Pandemic in Colombia: A Retrospective Cohort
Jose A Nuñez-Ramos1,2, Elias Forero Illera1,3, Jorge Luis Quintero Barrios1,4
1Health Sciences Division, Universidad del Norte, Barranquilla, COL.
Insights
COVID-19 mortality is high in hospitalized patients, particularly older individuals with type 2 diabetes mellitus and elevated LDH. Disease severity at admission is a key predictor of death.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- COVID-19 mortality varies significantly across populations due to diverse factors.
- Limited data exists on prognostic factors and mortality in COVID-19 patients from Latin America.
Purpose of the Study:
- To identify prognostic factors for mortality in hospitalized COVID-19 patients.
- To assess tocilizumab's impact on hyperinflammatory and severe COVID-19 cases (NEWS2 ≥ 7).
Main Methods:
- Retrospective cohort study of 136 hospitalized COVID-19 patients (May-July 2020).
- Multivariate logistic regression analysis to determine independent mortality predictors.
- Analysis included demographic data, laboratory results (LDH, lymphopenia, PaO2/FiO2), and disease severity scores (NEWS2).
Main Results:
- In-hospital mortality rate was 39.7%.
- Independent predictors of mortality included age > 65 years, type 2 diabetes mellitus, NEWS2 ≥ 7, and LDH > 400 U/L.
- Tocilizumab use did not significantly decrease in-hospital mortality, even in subgroups with hyperinflammation and severe disease.
Conclusions:
- Hospitalized COVID-19 patients face high mortality rates.
- Key mortality determinants are advanced age, comorbidities (especially type 2 diabetes), elevated LDH, and severe disease at admission.
- Early identification of high-risk patients is crucial for improving outcomes.
Abstract:
Introduction Different factors are critical when assessing COVID-19 mortality, and can explain why severity differs so widely among populations. However, there is little information regarding prognostic factors and mortality in COVID-19 from Latin American countries. Objectives To determine prognostic factors in hospitalized COVID-19 patients and to evaluate the impact of tocilizumab use in patients with hyperinflammatory syndrome and severe disease defined by the National Early Warning Score 2 (NEWS2) with a value greater than or equal to seven points. Materials and methods This retrospective cohort study included hospitalized COVID-19 patients from May to July 2020. A multivariate logistic regression analysis was performed to determine independent factors associated with mortality. Results A total of 136 patients required hospital admission. In-hospital mortality was 39.7%. Mortality was observed to be potentiated by older age, LDH serum levels and the presence of type 2 diabetes mellitus. Lymphopenia and lower PaO2/FiO2 ratio were more common in these patients. Similarly, patients who died were classified more frequently with severe disease. The independent factors associated with in-hospital mortality were age greater than 65 years, type 2 diabetes mellitus, NEWS2 greater than or equal to seven points and LDH greater than 400U/L. The use of Tocilizumab alone was not related with decreased in-hospital mortality. Subgroup analysis performed in patients with hyperinflammation and severe disease showed similar results. Conclusions COVID-19 mortality in hospitalized patients was high and mainly related with older age, comorbidities, LDH and the severity of disease at hospital admission.
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