Lam Eric, Gomez-Paz Sandra, Gonzalez-Mosquera Luis Fernando, Mirabella Steven, Cardenas-Maldonado Diana, Fogel Joshua, Rubinstein Sofia
Nassau University Medical Center Department of Medicine East Meadow, NY USA.
Department of Medicine Division of Nephrology & Hypertension East Meadow, NY USA.
J Acute Med. 2024 Jun 1;14(2):61-73. doi: 10.6705/j.jacme.202406_14(2).0002.
Coronavirus disease 2019 (COVID-19) has multiple organ system involvement but the association of organ system involvement with disease prognosis has not been reported. We study the association of organ systems involved with in-hospital mortality and hospital length of stay (LOS) in COVID-19.
Retrospective study of 808 consecutive patients with confirmed-laboratory diagnosis of COVID-19 in a New York hospital from March 1-May 15, 2020.
Increased number of organs systems involved was associated with increased odds for in-hospital mortality (odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.11-1.66, < 0.01) and increased LOS (B = 0.02, SE = 0.01, < 0.05). Increased platelet count was associated with decreased odds for mortality (OR: 0.996, 95% CI: 0.994-0.998, < 0.001). Increased white blood cell count was associated with increased odds for mortality (OR: 14.00, 95% CI: 3.41-57.38, < 0.001). Increased creatinine and glucose were each associated with increased LOS (B = 0.11, SE = 0.04, < 0.01, and B = 0.12, SE = 0.05, < 0.05, respectively). Increased odds for mortality were also found in high FiO2 oxygen requirement (OR: 11.63, 95% CI: 3.90-34.75, < 0.001) and invasive mechanical ventilation (OR: 109.93, 95% CI: 29.44-410.45, < 0.001).
Multiple organ systems involvement in COVID-19 is associated with worse prognosis. Clinical/laboratory values corresponding to each organ system may be used as prognostic tools in clinical settings to tailor treatments for COVID-19 patients.
2019冠状病毒病（COVID-19）会累及多个器官系统，但器官系统受累与疾病预后的关系尚未见报道。我们研究了COVID-19患者器官系统受累情况与院内死亡率及住院时间（LOS）之间的关系。
对2020年3月1日至5月15日在纽约一家医院连续收治的808例实验室确诊的COVID-19患者进行回顾性研究。
受累器官系统数量增加与院内死亡几率增加（比值比[OR]：1.36，95%置信区间[CI]：1.11 - 1.66，P < 0.01）及住院时间延长（B = 0.02，标准误[SE] = 0.01，P < 0.05）相关。血小板计数增加与死亡几率降低相关（OR：0.996，95% CI：0.994 - 0.998，P < 0.001）。白细胞计数增加与死亡几率增加相关（OR：14.00，95% CI：3.41 - 57.38，P < 0.001）。肌酐和血糖升高分别与住院时间延长相关（B = 0.11，SE = 0.04，P < 0.01；B = 0.12，SE = 0.05，P < 0.05）。高FiO₂吸氧需求（OR：11.63，95% CI：3.90 - 34.75，P < 0.001）和有创机械通气（OR：109.93，95% CI：29.44 - 410.45，P < 0.001）时死亡几率也增加。
COVID-19累及多个器官系统与预后较差相关。各器官系统对应的临床/实验室指标可作为临床环境中的预后工具，为COVID-19患者量身定制治疗方案。
