Az Adem, Sogut Ozgur, Akdemir Tarik, Ergenc Huseyin, Dogan Yunus, Cakirca Mustafa
University of Health Sciences, Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Bezmialem Vakif University, Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey.
Int J Gen Med. 2021 Jun 29;14:2989-3000. doi: 10.2147/IJGM.S317350. eCollection 2021.
We investigated potential predictive factors for mortality and disease severity from demographic and clinical data, comorbidities, and laboratory findings in patients with confirmed COVID-19 who were consecutively admitted to our tertiary hospital.
In this retrospective, single-center, observational study, we enrolled consecutive 540 adult patients who had COVID-19 confirmed by a molecular method. Patients were categorized into three groups based on disease severity. Patients' demographic and clinical characteristics, mortality rates, and mortality-associated factors were analyzed.
The overall mortality rate was 4.3% (23/540). Disease severity was mild in 40.9% (n = 221), severe in 53.7% (n = 290), and critical in 5.4% (n = 29) of the patients. There were significant differences among groups in terms of median white blood cell (WBC), hemoglobin, neutrophil, lymphocyte, and thrombocyte counts, as well as C-reactive protein (CRP), procalcitonin, lactate dehydrogenase (LDH), creatinine, albumin, D-dimer, ferritin, troponin, and fibrinogen levels. Furthermore, there were significant differences between surviving and non-surviving patient groups in terms of median WBC, hemoglobin, neutrophil, and lymphocyte counts, as well as CRP, procalcitonin, LDH, creatinine, albumin, D-dimer, and ferritin levels. CRP level (odds ratio [OR]: 1.020, 95% confidence interval [CI]: 1.009-1.032; p < 0.001), and CURB-65 score (OR: 4.004, 95% CI: 1,288-12,447; p = 0.017) were independently associated with disease severity and mortality.
On admission, WBC, neutrophil, lymphocyte, and platelet counts can be used to predict disease severity in patients with COVID-19. CRP, ferritin, LDH, creatinine, troponin, D-dimer, fibrinogen, and albumin levels can also be used to predict disease severity in these patients. Finally, elevated CRP level and high CURB-65 score were predictors of disease severity and mortality.
我们通过对连续入住我院三级医院的确诊新型冠状病毒肺炎（COVID-19）患者的人口统计学和临床数据、合并症及实验室检查结果进行研究，以探寻死亡和疾病严重程度的潜在预测因素。
在这项回顾性、单中心观察性研究中，我们纳入了540例经分子方法确诊为COVID-19的成年患者。根据疾病严重程度将患者分为三组。对患者的人口统计学和临床特征、死亡率及死亡相关因素进行分析。
总体死亡率为4.3%（23/540）。40.9%（n = 221）的患者疾病严重程度为轻症，53.7%（n = 290）为重症，5.4%（n = 29）为危重症。各组之间在白细胞（WBC）、血红蛋白、中性粒细胞、淋巴细胞和血小板计数中位数，以及C反应蛋白（CRP）、降钙素原、乳酸脱氢酶（LDH）、肌酐、白蛋白、D-二聚体、铁蛋白、肌钙蛋白和纤维蛋白原水平方面存在显著差异。此外，存活组与非存活组患者在WBC、血红蛋白、中性粒细胞和淋巴细胞计数中位数，以及CRP、降钙素原、LDH、肌酐、白蛋白、D-二聚体和铁蛋白水平方面也存在显著差异。CRP水平（比值比[OR]：1.020，95%置信区间[CI]：1.009 - 1.032；p < 0.001）和CURB-65评分（OR：4.004，95% CI：1.288 - 12.447；p = 0.017）与疾病严重程度和死亡率独立相关。
入院时，WBC、中性粒细胞、淋巴细胞和血小板计数可用于预测COVID-19患者的疾病严重程度。CRP、铁蛋白、LDH、肌酐、肌钙蛋白、D-二聚体、纤维蛋白原和白蛋白水平也可用于预测这些患者的疾病严重程度。最后，CRP水平升高和CURB-65评分高是疾病严重程度和死亡率的预测指标。
