Palus Damian, Gołębiewska Martyna, Piątek-Dalewska Olga, Grudziński Krzysztof, Kuziemski Krzysztof, Owczuk Radosław, Hoffmann Michał, Kozłowski Dariusz, Stefaniak Tomasz
Department of Hypertension and Diabetology, Medical University of Gdansk, Poland.
Department of Psychiatry, Medical University of Gdansk, Poland.
Cardiol J. 2025;32(2):120-129. doi: 10.5603/cj.103122. Epub 2025 Feb 25.
This study evaluates the impact of pre-existing comorbidities and in-hospital complications on COVID-19 mortality rates.
A retrospective single-center study was conducted using electronic health records from 640 COVID-19 patients hospitalized at the University Clinical Centre in Gdansk, Poland, between November 2020 and May 2021. Patients were categorized based on disease severity into stable or ICU wards based on the disease severity. Data on demographics, comorbidities, complications, and treatments were collected and verified. Statistical analyses, including odds ratios (ORs) and confidence intervals (CIs), assessed mortality risk factors supported by python-based processing.
The mean patient age was 67 years (SD ± 15.89), comprising 39% females (n = 250) and 60.94% males (n = 390). Mortality risk was highest in patients aged 65 years and older (OR 3.00; 95% CI, 1.97-4.60). Among the pre-existing comorbidities, chronic kidney disease (OR 3.28; 95% CI, 2.12-5.09), atrial fibrillation (OR 2.43; CI 95%, 1.63-3.61), and heart failure (OR 2.89; 95% CI, 1.91-4.37) were significant predictors of mortality. In hospital complications, such as severe respiratory failure requiring ICU ventilation (OR 23.59; 95% CI, 2.81-197.87), myocardial infarction (OR 25.43; 95% CI, 3.16-204.97), acute kidney injury requiring renal replacement therapy (OR 19.15; 95% CI, 6.49-56.51), sepsis (OR 7.22, 95% CI, 3.77-13.84), stroke, further increased mortality risk.
COVID-19 patients with pre-existing renal and cardiovascular conditions face a higher risk of fatal outcomes. Early diagnosis and intervention targeting these complications are vital to in reducing mortality. Further research is needed to reconcile disparities with existing literature.
本研究评估了既往合并症和院内并发症对新冠病毒疾病（COVID-19）死亡率的影响。
采用回顾性单中心研究，使用了2020年11月至2021年5月期间在波兰格但斯克大学临床中心住院的640例COVID-19患者的电子健康记录。根据疾病严重程度将患者分为稳定病房或重症监护病房（ICU）。收集并核实了人口统计学、合并症、并发症和治疗的数据。包括优势比（OR）和置信区间（CI）在内的统计分析评估了基于Python处理支持的死亡风险因素。
患者的平均年龄为67岁（标准差±15.89），其中女性占39%（n = 250），男性占60.94%（n = 390）。65岁及以上患者的死亡风险最高（OR 3.00；95% CI，1.97 - 4.60）。在既往合并症中，慢性肾脏病（OR 3.28；95% CI，2.12 - 5.09）、心房颤动（OR 2.43；CI 95%，1.63 - 3.61）和心力衰竭（OR 2.89；95% CI，1.91 - 4.37）是死亡的重要预测因素。院内并发症，如需要ICU机械通气的严重呼吸衰竭（OR 23.59；95% CI，2.81 - 197.87）、心肌梗死（OR 25.43；95% CI，3.16 - 204.97）、需要肾脏替代治疗的急性肾损伤（OR 19.15；95% CI，6.49 - 56.51）、脓毒症（OR 7.22，95% CI，3.77 - 13.84）、中风，进一步增加了死亡风险。
患有既往肾脏和心血管疾病的COVID-19患者面临更高的致命结局风险。针对这些并发症的早期诊断和干预对于降低死亡率至关重要。需要进一步研究以协调与现有文献的差异。
