Malundo Anna Flor G, Abad Cybele Lara R, Salamat Maria Sonia S, Sandejas Joanne Carmela M, Poblete Jonnel B, Planta Jose Eladio G, Morales Shayne Julieane L, Gabunada Ron Rafael W, Evasan Agnes Lorrainne M, Cañal Johanna Patricia A, Santos Julian A, Manto Jeffrey T, Mercado Maria Elizabeth P, Rojo Raniv D, Ornos Eric David B, Alejandria Marissa M
Division of Infectious Diseases, University of the Philippines - Philippine General Hospital, Taft Avenue, Ermita, Manila, National Capital Region, Philippines.
Division of Infectious Diseases, University of the Philippines - Philippine General Hospital, Manila, Philippines.
IJID Reg. 2022 Sep;4:134-142. doi: 10.1016/j.ijregi.2022.07.009. Epub 2022 Jul 14.
The aim of this study was to determine the predictors of mortality and describe laboratory trends among adults with confirmed COVID-19.
The medical records of adult patients admitted to a referral hospital with COVID-19 were retrospectively reviewed. Demographic and clinical characteristics, and laboratory parameters, were compared between survivors and non-survivors. Predictors of mortality were determined by multivariate analysis. Mean laboratory values were plotted across illness duration.
Of 1215 patients, 203 (16.7%) had mild, 488 (40.2%) moderate, 183 (15.1%) severe, and 341 (28.1%) critical COVID-19 on admission. In-hospital mortality was 18.2% (0% mild, 6.1% moderate, 15.8% severe, 47.5% critical). Predictors of mortality were age ≥ 60 years, COPD, qSOFA score ≥ 2, WBC > 10 × 10/L, absolute lymphocyte count < 1000, neutrophil ≥ 70%, PaO/FiO ratio ≤ 200, eGFR < 90 mL/min/1.73 m, LDH > 600 U/L, and CRP > 12 mg/L. Non-survivors exhibited an increase in LDH and decreases in PaO/FiO ratio and eGFR during the 2nd-3rd week of illness.
The overall mortality rate was high. Predictors of mortality were similar to those of other reports globally. Marked inflammation and worsening pulmonary and renal function were evident among non-survivors by the 2nd-3rd week of illness.
本研究旨在确定确诊为新型冠状病毒肺炎（COVID-19）的成人患者的死亡预测因素，并描述其实验室指标变化趋势。
对一家转诊医院收治的成年COVID-19患者的病历进行回顾性分析。比较幸存者和非幸存者的人口统计学和临床特征以及实验室参数。通过多变量分析确定死亡预测因素。绘制疾病持续时间内的平均实验室值。
1215例患者中，入院时203例（16.7%）为轻症，488例（40.2%）为中症，183例（15.1%）为重症，341例（28.1%）为危重症COVID-19。住院死亡率为18.2%（轻症0%，中症6.1%，重症15.8%，危重症47.5%）。死亡预测因素为年龄≥60岁慢性阻塞性肺疾病（COPD）、快速序贯器官衰竭评分（qSOFA）≥2、白细胞（WBC）>10×10⁹/L、绝对淋巴细胞计数<1000、中性粒细胞≥70%、动脉血氧分压/吸入氧分数（PaO₂/FiO₂）≤200、估算肾小球滤过率（eGFR）<90 mL/min/1.73 m²、乳酸脱氢酶（LDH）>600 U/L和C反应蛋白（CRP）>12 mg/L。非幸存者在发病第2至3周期间LDH升高，PaO₂/FiO₂和eGFR降低。
总体死亡率较高。死亡预测因素与全球其他报告相似。在发病第2至3周，非幸存者中明显存在炎症反应以及肺和肾功能恶化。
