Study on early markers of death in patients with COVID-19
1Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China. ydyuan1@hb2h.net.cn.
Insights
Early indicators of death in severe COVID-19 patients include heart disease, low lymphocyte counts, and high lactate levels. The MuLBSTA score also predicts mortality risk in critical coronavirus disease 2019 cases.
Area of Science:
- Critical care medicine
- Infectious diseases
- Epidemiology
Background:
- Coronavirus disease 2019 (COVID-19) rapidly spread globally after its discovery in December 2019.
- Identifying early indicators of mortality is crucial for managing severe and critical COVID-19 cases.
Purpose of the Study:
- To investigate early indicators of death in patients with severe and critical COVID-19.
- To identify independent risk factors associated with mortality in this patient population.
Main Methods:
- Retrospective cohort study of 162 severe and critical COVID-19 patients admitted to the Seventh Hospital of Wuhan.
- Clinical data collected from electronic medical records.
- Univariate and multivariate logistic regression analysis used to identify risk factors for death.
Main Results:
- The cohort had a 28-day mortality rate of 31.5%.
- Non-survival group showed significantly higher white blood cell count, decreased lymphocyte count, anemia, and thrombocytopenia.
- Independent risk factors for death included underlying heart disease, low lymphocyte count (< 1.0 × 10^9/L), impaired glomerular filtration rate (< 66), elevated lactate (> 2.2 mmol/L), higher SOFA score, lower oxygenation index, and higher MuLBSTA score.
Conclusions:
- Underlying heart disease, lymphocyte count, glomerular filtration rate, lactate levels, oxygenation index, SOFA score, and MuLBSTA score are significantly associated with the risk of death in severe and critical COVID-19 patients.
- These factors can serve as important early indicators for mortality prediction in severe COVID-19 cases.
Objective:
Coronavirus disease 2019 (COVID-19) was first discovered in December 2019, and since then rapidly spread worldwide. Our study aimed to investigate the early indicators of death in patients suffering from severe and critical COVID-19.
Patients And Methods:
A retrospective cohort study was conducted on patients with severe and critical COVID-19, admitted to the Seventh Hospital of Wuhan. Clinical information was collected from electronic medical records according to standardized data collection tables. Patients were divided into non-survival and survival groups based on the disease outcome. Using univariate and multivariate logistic regression analysis, and calculating odds ratios (OR) and 95% confidence intervals (CI), independent risk factors for death in severe and critically ill COVID-19 patients were identified.
Results:
The median age of 162 patients (57.4% males) was 67.5 years old. Patients in the non-survival group had significantly higher white blood cell count, decreased lymphocyte count, anemia and thrombocytopenia compared to patients in the survival group (p < 0.05). A 28-day mortality rate of the study cohort was 31.5%. Multivariate logistic regression analysis showed that underlying heart disease, lymphocyte count < 1.0 × 109/L, glomerular filtration rate < 66, lactate > 2.2 mmol/L, higher Sequential Organ Failure Assessment (SOFA) score, lower oxygenation index (OR 1.748; 95% CI 1.024-2.984; p=0.041) and higher "multi-lobar infiltration, hypo lymphocytosis, bacterial co-infection, smoking history, hypertension and age" (MuLBSTA) score (OR 1.601; 95% CI 1.062-2.415; p=0.025) were risk factors associated with death in patients with severe and critical COVID-19.
Conclusions:
Underlying heart disease, lymphocyte count, glomerular filtration rate, lactate, oxygenation index, SOFA score, and MuLBSTA score were associated with the risk of death in severe and critical COVID-19 patients.
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