School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
School of Medicine, Lebanese American University, Byblos, Lebanon.
PLoS One. 2022 Dec 1;17(12):e0278393. doi: 10.1371/journal.pone.0278393. eCollection 2022.
With the dire economic situation in Lebanon, many of the basic resources of the hospitals needed to help fight COVID-19 infections are not available. In this paper, we studied the possible factors associated with increased mortality in a sample of Lebanese adults enrolled in three hospitals.
In this retrospective cohort study, we analyzed data from 416 adults hospitalized in three institutions for a COVID-19 infection, from the opening of the COVID unit until their closure (period extending from March 2020 to June 2021). We used multivariate analyses to assess potential factors associated with COVID-19 mortality: gender, age, the presence of underlying medical conditions, and some medication taken during hospitalization.
Using variables related to baseline characteristics entered as independent variables, acute kidney injury (aOR = 4.057) and older age (aOR = 1.053) were associated with a higher probability of death. After adjusting baseline characteristics and factors related to admission entered as independent variables, enoxaparin intake (aOR = 0.435) was significantly associated with a lower probability of death, whereas old age (aOR = 1.049) and ventilation (aOR = 1.2) were significantly associated with higher odds of death. When all variables that showed significance in bivariate analysis were entered, old age (aOR = 1.243) and highest PaCO2 during hospitalization (aOR = 1.192) were significantly associated with higher mortality. With a weak effect, atrial fibrillation, COPD, and higher leucocyte counts on admission were significantly associated with higher odds of death.
These findings could help us prevent severe diseases in patients with several comorbidities and adjust therapeutic care to improve future outcomes. More studies should compare the outcome of different COVID-19 strains as well as the impact of vaccination on those with multiple comorbidities, especially on the mortality rate culminating from disease complications.
由于黎巴嫩严峻的经济形势,许多帮助抗击 COVID-19 感染所需的医院基本资源都无法获得。在本文中,我们研究了在三家医院就诊的黎巴嫩成年人样本中与死亡率增加相关的可能因素。
在这项回顾性队列研究中,我们分析了来自三家机构因 COVID-19 感染住院的 416 名成年人的数据,从 COVID 病房开放到关闭(从 2020 年 3 月到 2021 年 6 月)。我们使用多变量分析评估与 COVID-19 死亡率相关的潜在因素:性别、年龄、是否存在潜在的医疗条件以及住院期间服用的某些药物。
使用作为独立变量输入的与基线特征相关的变量,急性肾损伤(aOR = 4.057)和年龄较大(aOR = 1.053)与更高的死亡概率相关。在调整基线特征和作为独立变量输入的入院相关因素后,依诺肝素摄入(aOR = 0.435)与较低的死亡概率显著相关,而年龄较大(aOR = 1.049)和通气(aOR = 1.2)与较高的死亡风险显著相关。当所有在双变量分析中表现出显著意义的变量都被输入时,年龄较大(aOR = 1.243)和住院期间最高的 PaCO2(aOR = 1.192)与较高的死亡率显著相关。房颤、COPD 和入院时较高的白细胞计数的影响较弱,但与较高的死亡风险显著相关。
这些发现可以帮助我们预防患有多种合并症的患者出现严重疾病,并调整治疗护理以改善未来的结果。应开展更多研究比较不同 COVID-19 株的结果以及接种疫苗对患有多种合并症的患者的影响,尤其是对因疾病并发症导致的死亡率的影响。