Abstract
BackgroundData of critically ill COVID-19 patients are being evaluated worldwide, not only to understand the various aspects of the disease and to refine treatment strategies but also to improve clinical decision-making. For clinical decision-making in particular, prognostic factors of a lethal course of the disease would be highly relevant.MethodsIn this retrospective cohort study, we analyzed the first 59 adult critically ill Covid-19 patients treated in one of the intensive care units of the University Medical Center Regensburg, Germany. Using uni- and multivariable regression models, we extracted a set of parameters that allowed for prognosing in-hospital mortality.ResultsWithin the cohort, 19 patients died (mortality 32.2%). Blood pH value, mean arterial pressure, base excess, troponin, and procalcitonin were identified as highly significant prognostic factors of in-hospital mortality. However, no significant differences were found for other parameters expected to be relevant prognostic factors, like low arterial partial pressure of oxygen or high lactate levels. In the multivariable logistic regression analysis, the pH value and the mean arterial pressure turned out to be the most influential prognostic factors for a lethal course.
Highlights
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a new beta coronavirus that was identified as the cause of coronavirus disease 2019 (COVID-19) in early 2020
Blood pH value, mean arterial pressure, base excess, troponin, and procalcitonin were identified as highly significant prognostic factors of in-hospital mortality
We first screened the current literature for any parameters to be used as possible prognosis factors of good or bad outcomes in patients with COVID-19; we added parameters that we considered crucial in everyday intensive care treatment
Summary
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a new beta coronavirus that was identified as the cause of coronavirus disease 2019 (COVID-19) in early 2020. In the spring and summer of 2020, about 10% of those infected with SARS-CoV-2 in Germany required hospital treatment, of whom 14% had to be treated at an intensive care unit (ICU). The complication rate depended on both age and comorbidities and characterized the patients who required intensive care treatment [8]. For patients with COVID-19 who require ICU treatment, various parameters have already been suggested as prognostic factors of outcome. Mesas et al identified Interleucin 6 (IL-6) together with pre-existing diseases as prognostic factors of a lethal course in patients under the age of 60 and elevated bilirubin and liver enzymes together with decreased albumin in patients older than 60 years [12]. For clinical decision-making in particular, prognostic factors of a lethal course of the disease would be highly relevant
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