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Prediction of mortality in hospitalized Egyptian patients with Coronavirus disease-2019: A multicenter retrospective
Muhammad M AbdelGhaffar1,2, Dalia Omran2,3, Ahmed Elgebaly4
1Gastroenterology & Infectious Diseases Department, Ahmed Maher Teaching Hospital, Cairo, Egypt.
Insights
Older age, diabetes, hypertension, and hypoxemia significantly increase COVID-19 mortality risk in Egyptian patients. However, anticoagulants and azithromycin use were associated with reduced mortality in this hospitalized cohort.
Area of Science:
- Epidemiology
- Clinical Medicine
- Infectious Diseases
Background:
- COVID-19 has posed a significant global health challenge.
- Understanding mortality predictors is crucial for patient management.
- Egyptian data on COVID-19 mortality characteristics were limited.
Purpose of the Study:
- To identify epidemiological, clinical, and laboratory factors associated with mortality in hospitalized Egyptian COVID-19 patients.
- To determine independent predictors of mortality using statistical modeling.
Main Methods:
- A multicenter, retrospective study of 3712 hospitalized COVID-19 patients from April to July 2020.
- Generalized linear models and stepwise logistic regression were used for analysis.
- Odds ratios (OR) and 95% confidence intervals (CI) were calculated.
Main Results:
- Mortality rate was 24.2% (900 deaths).
- Independent predictors of mortality included age ≥ 60, diabetes, hypertension, chronic renal insufficiency, tachycardia, hypoxemia, and low Glasgow Coma Scale (GCS) score.
- Use of anticoagulants (OR=0.4) and azithromycin (OR=0.16) were associated with reduced mortality.
Conclusions:
- Age over 60, comorbidities (diabetes, hypertension, renal insufficiency), tachycardia, hypoxemia, and altered consciousness are key predictors of mortality in hospitalized Egyptian COVID-19 patients.
- Anticoagulant therapy and azithromycin administration showed a protective association with mortality.
- These findings highlight critical factors for risk stratification and treatment strategies in COVID-19 patients.
Abstract:
We aimed to assess the epidemiological, clinical, and laboratory characteristics associated with mortality among hospitalized Egyptian patients with COVID-19. A multicenter, retrospective study was conducted on all polymerase chain reaction (PCR)-confirmed COVID-19 cases admitted through the period from April to July 2020. A generalized linear model was reconstructed with covariates based on predictor's statistical significance and clinically relevance. The odds ratio (OR) was calculated by using stepwise logistic regression modeling. A total of 3712 hospitalized patients were included; of them, 900 deaths were recorded (24.2%). Compared to survived patients, non-survived patients were more likely to be older than 60 years (65.7%), males (53.6%) diabetic (37.6%), hypertensive (37.2%), and had chronic renal insufficiency (9%). Non-survived patients were less likely to receive azithromycin (p <0.001), anticoagulants (p <0.001), and steroids (p <0.001). We found that age ≥ 60 years old (OR = 2.82, 95% CI 2.05-3.86; p <0.0001), diabetes mellitus (OR = 1.58, 95% CI 1.14-2.19; p = 0.006), hypertension (OR = 1.69, 95% CI 1.22-2.36; p = 0.002), chronic renal insufficiency (OR = 3.15, 95% CI 1.84-5.38; p <0.0001), tachycardia (OR = 1.65, 95% CI 1.22-2.23; p <0.001), hypoxemia (OR = 5.69, 95% CI 4.05-7.98; p <0.0001), GCS <13 (OR 515.2, 95% CI 148.5-1786.9; p <0.0001), the use of therapeutic dose of anticoagulation (OR = 0.4, 95% CI 0.22-0.74, p = 0.003) and azithromycin (OR = 0.16, 95% CI 0.09-0.26; p <0.0001) were independent negative predictors of mortality. In conclusion, age >60 years, comorbidities, tachycardia, hypoxemia, and altered consciousness level are independent predictors of mortality among Egyptian hospitalized patients with COVID-19. On the other hand, the use of anticoagulants and azithromycin is associated with reduced mortality.
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