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Risk factors for mortality in critically ill patients with COVID-19: a multicenter retrospective case-control study

Jinghua Gao1,2, Li Zhong3, Ming Wu4

  • 1The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510010, China.

BMC Infectious Diseases
|June 25, 2021
PubMed

Insights

Identifying risk factors for death in critically ill COVID-19 patients is crucial. Basic illness, lymphopenia, higher SOFA scores, and critical illness severity are linked to in-hospital mortality risk.

Area of Science:

  • Critical care medicine
  • Infectious diseases
  • Prognostic factor analysis

Background:

  • The global spread of COVID-19 necessitates identifying mortality risk factors in severe cases.
  • Ongoing increases in COVID-19 cases and deaths underscore the need for prognostic research.

Purpose of the Study:

  • To determine independent risk factors associated with 28-day and 60-day survival in critically ill COVID-19 patients.
  • To analyze the relationship between clinical indicators and mortality in severe COVID-19.

Main Methods:

  • Collected demographic and clinical data from severe COVID-19 inpatients.
  • Employed univariable and multivariable Cox regression and survival curve analysis.
  • Assessed risk factors for 28-day and 60-day survival.

Main Results:

  • Multivariable analysis identified basic illness (HR 6.455), lymphopenia (HR 0.373), higher SOFA score (HR 1.171), and critical illness (HR 0.191) as significant factors.
  • Lower lymphocyte counts, elevated SOFA and APACHE II scores, low PaO2/FiO2, and high IL-6 and CRP levels correlated with increased mortality.
  • Specific thresholds for lymphocyte count (<0.8×10^9/L), SOFA score (>3), APACHE II score (>7), PaO2/FiO2 (<200 mmHg), IL-6 (>120 pg/ml), and CRP (>52 mg/L) were associated with poor outcomes.

Conclusions:

  • Critical illness severity, lymphocyte count, SOFA score, APACHE II score, PaO2/FiO2 ratio, IL-6, and CRP levels on admission are associated with poor prognosis in COVID-19.
  • These factors can aid in stratifying risk and guiding clinical management for severe COVID-19 patients.
Abstract

Keywords:
COVID-19MortalityRisk factorsSARS-COV-2

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