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Predictors of mortality, ICU hospitalization, and extrapulmonary complications in COVID-19 patients
M Martinot1, M Eyriey2, S Gravier1
1Infectious Diseases Department, Hôpitaux Civils, 39, avenue de la liberté, 68024 Colmar, France.
Insights
Severe COVID-19 in France led to significant ICU admissions and deaths. Key risk factors included older age, male sex, comorbidities, and elevated inflammatory markers, with frequent extrapulmonary complications observed.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- A significant coronavirus disease 2019 (COVID-19) outbreak occurred in Northeastern France during spring 2020.
- Understanding risk factors and complications is crucial for managing severe COVID-19 cases.
Purpose of the Study:
- To compare severe versus non-severe COVID-19 patients.
- To identify risk factors for intensive care unit (ICU) hospitalization and death.
- To describe the frequency of extrapulmonary complications in COVID-19 patients.
Main Methods:
- Retrospective observational cohort study of 600 patients admitted to Colmar Hospital in March 2020.
- Analysis of baseline characteristics, comorbidities, and clinical outcomes.
- Comparison between survivors and non-survivors, and between ICU and non-ICU patients.
Main Results:
- 19.1% of patients died, and 25.5% required ICU admission.
- Independent risk factors for death included older age, male sex, chronic diseases, and elevated C-reactive protein (CRP) and creatinine.
- Frequent extrapulmonary complications included acute renal injury (13.3%), cardiovascular events (5.5%), and venous thromboembolism (4%).
Conclusions:
- Older age, male sex, comorbidities, and inflammatory markers are significant predictors of mortality in severe COVID-19.
- Extrapulmonary complications are common, particularly in ICU patients.
- This study provides critical insights into COVID-19 severity and outcomes in the French outbreak.
Objective:
A major coronavirus disease 2019 (COVID-19) outbreak occurred in Northeastern France in spring 2020. This single-center retrospective observational cohort study aimed to compare patients with severe COVID-19 and those with non-severe COVID-19 (survivors vs. non-survivors, ICU patients vs. non-ICU patients) and to describe extrapulmonary complications.
Patients And Methods:
We included all patients with a confirmed diagnosis of COVID-19 admitted to Colmar Hospital in March 2020.
Results:
We examined 600 patients (median age 71.09 years; median body mass index: 26.9 kg/m2); 57.7% were males, 86.3% had at least one comorbidity, 153 (25.5%) required ICU hospitalization, and 115 (19.1%) died. Baseline independent factors associated with death were older age (>75 vs. ≤75 years), male sex, oxygen supply, chronic neurological, renal, and pulmonary diseases, diabetes, cancer, low platelet and hemoglobin counts, and high levels of C-reactive protein (CRP) and serum creatinine. Factors associated with ICU hospitalization were age <75 years, oxygen supply, chronic pulmonary disease, absence of dementia, and high levels of CRP, hemoglobin, and serum creatinine. Among the 600 patients, 80 (13.3%) had an acute renal injury, 33 (5.5%) had a cardiovascular event, 27 (4.5%) had an acute liver injury, 24 (4%) had venous thromboembolism, eight (1.3%) had a neurological event, five (0.8%) had rhabdomyolysis, and one had acute pancreatitis. Most extrapulmonary complications occurred in ICU patients.
Conclusion:
This study highlighted the main risk factors for ICU hospitalization and death caused by severe COVID-19 and the frequency of numerous extrapulmonary complications in France.
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