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Observational Study
Early predictors of mortality for moderate to severely ill patients with Covid-19.
- Gökhan Aksel, Mehmet Muzaffer İslam, Abdullah Algın, Serkan Emre Eroğlu, Gökselin Beleli Yaşar, Enis Ademoğlu, and Ümit Can Dölek.
- Emergency Medicine Department, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey. Electronic address: aksel@gokhanaksel.com.
- Am J Emerg Med. 2021 Jul 1; 45: 290296290-296.
BackgroundDetermining the factors affecting the mortality and clinical conditions of the patients with Covid-19 are indispensable needs in developing patient treatment algorithms. We aimed to determine the parameters that can predict the mortality of moderate to severely ill patients with laboratory confirmed Covid-19.MethodsModerate to severely ill, Covid-19 patients older than 18 years were included. Mild Covid-19 patients and the ones with negative polymerase chain reaction test results were excluded from the study. The primary outcome of the study was 30-day mortality rate and we aimed to determine the factors affecting mortality in moderate to severely ill Covid-19 patients.Results168 patient results were analyzed. Median age of the patients was 59.5 (48.3 to 76) and 90 (53.6%) were male. According to multivariate regression analysis results, the presence of any comorbid disease (p = 0.027, HR = 26.11 (95%CI: 1.45 to 471.31)), elevated C-reactive protein levels (CRP) (p < 0.001, HR = 1.24 (95%CI: 1.11 to 1.38)) and presence of dyspnea (p = 0.026, HR = 4.26 ((95%CI: 1.19 to 15.28)) were found to significantly increase the mortality, while high pulse O 2 saturation level (p < 0.001, HR = 0.90 (95%CI: 0.82 to 0.99) was found to decrease. When receiver operating characteristic curve was created for laboratory tests, it was determined that white blood cell counts, neutrophil counts, CRP levels and neutrophil/lymphocyte ratio predicted mortality while Lymphocyte levels did not.ConclusionDyspnea, the presence of any comorbid disease, elevated CRP levels, and low pulse O 2 saturation levels predict mortality in moderate to severely ill Covid-19 patients.Copyright © 2020 Elsevier Inc. All rights reserved.
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