Abstract
The coronavirus disease 2019 (COVID-19) is one of the greatest clinical challenges of the last decades. Clinical factors associated with severity of the disease remain unclear. The aim of the study was to characterize Polish patients hospitalized due to COVID-19 and to evaluate potential prognostic factors of severe course of the disease. An observational study was conducted from March to July 2020 in the Pulmonology and Allergology Department of the University Hospital in Kraków, Poland. Consecutive patients with confirmed SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection were enrolled, and data about past medical history, signs and symptoms, laboratory results, imaging studies results, in-hospital management and outcomes was prospectively gathered. The study sample comprised 100 patients at the mean age of 59.2 (SD 16.1) years among whom 63 (63.0%) were male. Among them 10 (10.0%) died, 47 (47%) presented respiratory failure, 15 (15.0%) were transferred to the intensive care unit, 17 (17.0%) developed acute kidney injury, 7 (7.0%) had sepsis and 10 (10.0%) were diagnosed with pulmonary embolism. Multivariable analysis revealed age (OR 1.1; 95% CI 1.01-1.15), body mass index (BMI; OR 1.24; 95% CI 1.01-1.53), modified early warning score (MEWS; OR 3.95; 95% CI 1.48-12), the highest d-dimer value (OR 1.73; 95% CI 1.03-2.9) and lactate dehydrogenase (LDH; OR 1.16; 95% CI 1.03-1.3) to be associated with severe course of COVID-19. This observational study showed that almost half of hospitalized patients with COVID-19 developed respiratory failure in the course of the disease. Increasing age, BMI, MEWS, d-dimer value and LDH concentration were associated with the severity of COVID-19.
Highlights
The coronavirus disease 2019 (COVID-19) is one of the greatest clinical challenges of the last decades
There are several reports describing an increased incidence of injuries to the heart, kidneys, muscles, gastrointestinal tract and the nervous system among COVID-19 patients [1,2,3]. Another significant factor influencing outcomes of persons infected with SARS-CoV-2 is an increased incidence of thromboembolic complications which is secondary to severe disturbances in coagulation and fibrinolysis as well as endothelial damage, sometimes referred to as COVID-19-associated coagulopathy [4, 5]
Multivariable analysis revealed that severe course of COVID-19 is associated with increased age, body mass index (BMI), modified early warning score (MEWS) on admission, the highest d-dimer value during hospitalization and baseline lactate dehydrogenase (LDH) concentration
Summary
The coronavirus disease 2019 (COVID-19) is one of the greatest clinical challenges of the last decades. The aim of the study was to characterize Polish patients hospitalized due to COVID-19 and to evaluate potential prognostic factors of severe course of the disease. Conclusion: This observational study showed that almost half of hospitalized patients with COVID-19 developed respiratory failure in the course of the disease. There are several reports describing an increased incidence of injuries to the heart, kidneys, muscles, gastrointestinal tract and the nervous system among COVID-19 patients [1,2,3] Another significant factor influencing outcomes of persons infected with SARS-CoV-2 is an increased incidence of thromboembolic complications which is secondary to severe disturbances in coagulation and fibrinolysis as well as endothelial damage, sometimes referred to as COVID-19-associated coagulopathy [4, 5]. At the time of the study, only systemic glucocorticoids were recognized to reduce mortality in several randomized controlled trials [7]
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