Paciorek Marcin, Bieńkowski Carlo, Kowalska Justyna Dominika, Skrzat-Klapaczyńska Agata, Bednarska Agnieszka, Krogulec Dominika, Cholewińska Grażyna, Kowalski Jacek, Podlasin Regina, Ropelewska-Łącka Katarzyna, Wasilewski Piotr, Boros Piotr W, Martusiewicz-Boros Magdalena M, Pulik Piotr, Pihowicz Andrzej, Horban Andrzej
Department of Adults' Infectious Diseases, Medical University of Warsaw, 02-001 Warsaw, Poland.
Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland.
J Clin Med. 2023 Sep 28;12(19):6264. doi: 10.3390/jcm12196264.
COVID-19 is a disease characterized by high in-hospital mortality, which seems to be dependent on many predisposing factors.
The aim of this study was to analyze the clinical symptoms, abnormalities in the results of laboratory tests, and coexisting chronic diseases that independently affected the risk of in-hospital mortality in patients with COVID-19.
We analyzed the records of patients with COVID-19 who were hospitalized from 6 March 2020 to 30 November 2021.
Out of the entire group of 2138 patients who were analyzed, 12.82% died during hospitalization. In-hospital mortality was independently associated with older age (OR 1.53, 95% CI 1.20-1.97); lower arterial blood oxygen saturation (OR 0.95, 95% CI 0.92-0.99); the presence of a neoplasm (OR 4.45, 95% CI 2.01-9.62), a stomach ulcer (OR 3.35, 95% CI 0.94-11.31), and dementia (OR 3.40, 95% CI 1.36-8.26); a higher score on the SOFA scale (OR 1.73, 95% CI 1.52-1.99); higher lactate dehydrogenase (LDH) (OR 1.08, 95% CI 1.05-1.12); higher N-terminal pro-brain natriuretic peptide (NT pro BNP) (OR 1.06, 95% CI 1.01-1.11); and lower total bilirubin in blood concentration (OR 0.94, 95% CI 0.90-0.99).
We found that low oxygen saturation, old age, and the coexistence of cancer, gastric ulcers, and dementia syndrome were variables that independently increased mortality during hospitalization due to COVID-19. Moreover, we found that decreased platelet count and bilirubin concentration and increased levels of LDH and NT-proBNP were laboratory test results that independently indicated a higher risk of mortality. We also confirmed the usefulness of the SOFA scale in predicting treatment results. The ability to identify mortality risk factors on admission to hospital will facilitate both adjusting the intensity of treatment and the monitoring of patients infected with SARS-CoV-2.
新型冠状病毒肺炎（COVID-19）是一种以医院内死亡率高为特征的疾病，其死亡率似乎取决于许多诱发因素。
本研究旨在分析临床症状、实验室检查结果异常以及并存的慢性疾病，这些因素独立影响COVID-19患者的医院内死亡风险。
我们分析了2020年3月6日至2021年11月30日期间住院的COVID-19患者的记录。
在分析的2138例患者中，12.82%在住院期间死亡。医院内死亡率与以下因素独立相关：年龄较大（比值比[OR]1.53，95%置信区间[CI]1.20-1.97）；动脉血氧饱和度较低（OR 0.95，95%CI 0.92-0.99）；存在肿瘤（OR 4.45，95%CI 2.01-9.62）、胃溃疡（OR 3.35，95%CI 0.94-11.31）和痴呆（OR 3.40，95%CI 1.36-8.26）；序贯器官衰竭评估（SOFA）量表得分较高（OR 1.73，95%CI 1.52-1.99）；乳酸脱氢酶（LDH）水平较高（OR 1.08，95%CI 1.05-1.12）；N末端脑钠肽前体（NT pro BNP）水平较高（OR 1.06，95%CI 1.01-1.11）；以及血液中总胆红素浓度较低（OR 0.94，95%CI 0.90-0.99）。
我们发现低氧饱和度、高龄以及癌症、胃溃疡和痴呆综合征的并存是独立增加COVID-19住院期间死亡率的变量。此外，我们发现血小板计数降低、胆红素浓度降低以及LDH和NT-proBNP水平升高是独立表明较高死亡风险的实验室检查结果。我们还证实了SOFA量表在预测治疗结果方面的有用性。入院时识别死亡风险因素的能力将有助于调整治疗强度以及对感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者进行监测。
