• Tanya Mohammadi, Mehdi Rezaee, Seyed Mehdi Shahnematollahi, Amirhossein Fakhre Yaseri, Soolmaz Ghorbani, Shaghayegh Delshad Namin, and Babak Mohammadi.
• School of Mathematics, Statistics, and Computer Science, College of Science, University of Tehran, Tehran, Iran.
• J Natl Med Assoc. 2023 Oct 1; 115 (5): 500508500-508.

BackgroundRisk stratification enables care providers to make the proper clinical decision for the management of patients with COVID-19 infection. We aimed to explore changes in the importance of predictors for inpatient mortality of COVID-19 over one month.MethodsThis research was a secondary analysis of data from in-hospital patients with COVID-19 infection. Individuals were admitted to four hospitals, New York, USA. Based on the length of hospital stay, 4370 patients were categorized into three mutually exclusive interval groups, day 1, day 2-7, and day 8-28. We measured changes in the importance of twelve confirmed predictors for mortality over one month, using principal component analysis.ResultsOn the first day of admission, there was a higher risk for organ dysfunction, particularly in elderly patients. On day 1, serum aspartate aminotransferase and sodium were also associated with an increased risk of mortality, while normal troponin opposes in-hospital death. With time, the importance of high aspartate aminotransferase and sodium concentrations decreases, while the variable quality of high troponin levels increases. Our study suggested the importance of maintaining normal blood pressure early in the management of patients. High serum concentrations of creatinine and C-reactive protein remain poor prognostic factors throughout the 28 days. The association of age with mortality increases with the length of hospital stay.ConclusionThe importance of some patients' characteristics changes with the length of hospital stay. This should be considered in developing and deploying predictive models and the management of patients with COVID-19 infection.Copyright © 2023 National Medical Association. Published by Elsevier Inc. All rights reserved.

14 keywords...

hide…