Risk factors for clinical deterioration in patients admitted for COVID-19: A case-control study

Area of Science:

• Infectious Diseases
• Pulmonology
• Critical Care Medicine

Background:

• Clinical deterioration in COVID-19 patients presents a significant challenge, with ongoing debate regarding the most reliable predictive factors.
• Early identification of high-risk individuals is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To identify key predictors and risk factors associated with clinical deterioration among patients hospitalized with COVID-19.
• To develop a model for predicting severe outcomes in hospitalized COVID-19 cases.

Main Methods:

• A nested case-control study was conducted within a cohort across 13 acute care centers.
• Cases were defined as patients with COVID-19 experiencing severe acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, or death.
• Conditional logistic regression analysis was employed to identify independent predictors of clinical deterioration.

Main Results:

• The study included 99 cases and 198 controls.
• Significant independent predictors of deterioration included emergency department oxygen saturation ≤90%, pathological chest X-ray, C-reactive protein (CRP) >100 mg/dL, and thrombocytopenia (<150,000 platelets/µL).
• A medical history of acute myocardial infarction, chronic obstructive pulmonary disease (COPD), or hypertension (HT) were also strongly associated with increased risk.

Conclusions:

• The identified variables are valuable for clinical practice in detecting COVID-19 patients at high risk of adverse outcomes.
• This predictive model can aid clinicians in risk stratification and management strategies for hospitalized COVID-19 patients.