Clinical features and major bleeding predictors for 161 fatal cases of COVID-19: A retrospective observational study

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Hematology

Background:

• COVID-19 is associated with a high risk of complications, particularly in non-survivors.
• Understanding patient characteristics and laboratory markers in non-survivors is crucial for improving outcomes.
• Major bleeding is a significant in-hospital complication in critically ill COVID-19 patients.

Purpose of the Study:

• To investigate patient characteristics and laboratory parameters in COVID-19 non-survivors.
• To identify risk factors associated with major bleeding complications in this patient group.
• To explore the correlation between laboratory parameter changes and in-hospital events.

Main Methods:

• Retrospective study of 161 COVID-19 non-survivors admitted to the intensive care unit.
• Data collection included patient demographics, comorbidities, and laboratory values (D-dimer, platelet count, CRP, troponin, INR) on days 1, 5, and 10.
• Multiple logistic regression analysis was used to identify independent predictors of major bleeding.

Main Results:

• The median age of non-survivors was 69.8 years, with 59% being male.
• Common complications included ARDS (85%), acute kidney injury (40%), myocardial injury (70%), and major bleeding (39%).
• Independent predictors of major bleeding were age, hypertension, diabetes mellitus, use of aspirin or LMWH, hemoglobin, D-dimer, INR, and acute kidney injury.

Conclusions:

• A high proportion of COVID-19 non-survivors experienced major bleeding complications.
• Several clinical and laboratory factors independently predict major bleeding in critically ill COVID-19 patients.
• These findings underscore the importance of monitoring and managing bleeding risk in severe COVID-19 cases.