Division of Geriatric Medicine, Department of Family Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA.
Department of Internal Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA.
J Med Virol. 2021 May;93(5):2875-2882. doi: 10.1002/jmv.26750. Epub 2021 Feb 19.
The coronavirus disease 2019 (COVID-19) pandemic continues to cause significant morbidity and mortality worldwide. This study aims to identify specific lab markers, complications, and treatments that may be associated with increased mortality in COVID-19 patients. This study is retrospective in nature; it included 217 COVID-19 positive patients who were admitted to a ProMedica Health System hospital in Northwest Ohio, United States, between March 25 and June 16, 2020. We collected various laboratory values, complications, and treatment courses. T test and χ analyses were used to predict mortality. COVID-19 test was confirmed via polymerase chain reaction. Of 217 patients included in the study, the mean age of the population was 63.13 (SD, 17.8), of which 194 (89.4%, mean age 61.7 years) survived while 23 (10.6%, mean age 74.6 years) died. Among them, 53% were females and 47% male. Laboratory values that were associated with mortality were low hemoglobin (p = .0046), elevated INR (p = .0005), low platelets (p = .0246) and elevated procalcitonin (p = .0472). Marginally significant laboratory values included elevated troponin (p = .0661), and elevated creatinine (p = .0741). Treatment with either antibiotic, antifungals, antivirals, blood transfusion, steroids, and intubation were all statistically significant for mortality. COVID-19 related complications with either ARDS, myocarditis, elevated INR, septic shock, or age greater than 63 were significant predictors of mortality. Low hemoglobin, elevated INR, Low platelet, elevated procalcitonin, treated with either antibiotic, antifungal, antiviral, blood transfusion, steroids, and intubation are associated with high mortality related to COVID-19 infection. Healthcare professionals must be aware of these predictors.
2019 年冠状病毒病（COVID-19）大流行继续在全球范围内造成重大发病率和死亡率。本研究旨在确定可能与 COVID-19 患者死亡率增加相关的特定实验室标志物、并发症和治疗方法。本研究为回顾性研究；共纳入 2020 年 3 月 25 日至 6 月 16 日期间在美国俄亥俄州西北部 ProMedica 健康系统医院住院的 217 例 COVID-19 阳性患者。我们收集了各种实验室值、并发症和治疗过程。使用 t 检验和 χ 分析预测死亡率。COVID-19 检测通过聚合酶链反应（PCR）确认。在纳入研究的 217 例患者中，人群的平均年龄为 63.13（标准差 17.8），其中 194 例（89.4%，平均年龄 61.7 岁）存活，23 例（10.6%，平均年龄 74.6 岁）死亡。其中，女性占 53%，男性占 47%。与死亡率相关的实验室值为低血红蛋白（p=0.0046）、国际标准化比值（INR）升高（p=0.0005）、血小板减少（p=0.0246）和降钙素原升高（p=0.0472）。具有边缘显著性的实验室值包括肌钙蛋白升高（p=0.0661）和肌酐升高（p=0.0741）。抗生素、抗真菌药、抗病毒药、输血、类固醇和插管治疗均与死亡率统计学相关。ARDS、心肌炎、INR 升高、感染性休克或年龄大于 63 岁与 COVID-19 相关的并发症是死亡率的重要预测指标。低血红蛋白、INR 升高、血小板减少、降钙素原升高、抗生素、抗真菌药、抗病毒药、输血、类固醇和插管治疗与 COVID-19 感染相关的高死亡率相关。医疗保健专业人员必须意识到这些预测指标。
