Purpose: Romania is one of the European countries that has been hit the hardest by the severe acute respiratory syndrome caused by the new coronavirus SARS-CoV-2, with over 1.91 million reported cases and over 59,257 deaths. The aim of this study was to identify the main predictors of death in hospitalized patients.
Patients and methods: In the period from 1 March 2020 to 30 June 2021, an observational, retrospective, randomized, case-control study was conducted, which included a sample of 139 patients who died in hospital and another sample of 275 patients who had been discharged in an improved or healed condition. Confirmation of COVID-19 cases was performed by RT-PCR from nasopharyngeal and oropharyngeal exudates. Statistical data were analyzed by logistic regression, Cox regression and a comparison of survival curves by the log-rank (Mantel-Cox) test.
Results: The most powerful logistic regression model identified the following independent predictors of death: history of coagulopathy HR = 30.73 [1.94-487.09], p = 0.015; high percentage of neutrophils HR = 1.09 [1.01-1.19], p = 0.027; and decreased blood-oxygenation HR = 53881.97 [1762.24-1647489.44], p < 0.001. Cox regression identified the following factors that influenced the evolution of cases: history of coagulopathy HR = 2.44 [1.38-4.35], p = 0.000; O2 saturation HR = 0.98 [0.96-0.99], p = 0.043; serum creatinine HR = 1.23 [1.08-1.39], p = 0.001; dyspnea on admission HR = 2.99 [1.42-6.30], p = 0.004; hospitalization directly in the ICU HR = 3.803 [1.97-7.33], p < 0.001; heart damage HR = 16.76 [1.49-188.56], p = 0.022; and decreased blood-oxygenation HR = 35.12 [5.92-208.19], p < 0.001.
Conclusion: Knowledge of the predictors of death in hospitalized patients allows for the future optimization of triage and therapeutic case management for COVID-19.
Keywords: COVID-19; comorbidities; complications; protection factors; risk factors; survival.
© 2022 Laza et al.