Factors associated with mortality in patients hospitalized for COVID-19 in Spain. Data from the RERFAR registry

Abstract

ObjectiveTo determine the baseline characteristics associated with higher mortality at 42 days in patients hospitalized for COVID-19 in Spain. MethodThe study analyzed a prospective cohort of hospitalized COVID-19 patients. The dependent variable was 42-day mortality. Data on the subjects’ demographic and clinical characteristics, comorbidities, usual therapy and supportive interventions and treatments was collected within 48 hours from admission. To determine the potential association of the data with mortality, a multivariate analysis was performed using logistic regression. Results15,628 patients were included, 18.2% of whom (n = 2,806) died during the study period. According to the multivariate analysis, the variables that were significantly associated (p < 0.05) with mortality upon admission were: being referred from a nursing home (OR 1.9); having a high respiratory rate (OR 1,5); having moderate (OR 1.7) or severe (OR 2.9) pneumonia (CURB-65); aspartate aminotransferase transaminase ≥ 100 IU/1 (OR 2.1); lactate dehydrogenase ≥ 360 IU/L (OR 1.6); procalcitonin > 0.5 ng/mL (OR 1.8); creatine kinase ≥ 294 U/L (OR 1.5); D-dimer > 3,000 ng/mL (OR 1.5); hemoglobin < 11.6 g/dL (OR 1.4) and C-reactive protein > 120 mg/L (OR 1.2; requiring respiratory support within the first 48 hours (oxygen therapy [OR 2.0], non-invasive ventilation [OR 2.8], and mechanical ventilation [OR 3.5]); and being treated with interferon-beta (OR 1.5). On the contrary, being under 80 years of age was associated with lower mortality. ConclusionsThe analysis, based on the data in the RERFAR registry, showed that the factors associated with poorer prognosis were older age, assessed using the CURB-65 scale, level of respiratory support required, severe pneumonia (CURB-65), hypertransaminasemia, elevated creatine kinase, lactate dehydrogenase, and D-dimer levels, anemia, and elevated respiratory rate.