Markers predicting critical illness and mortality in COVID-19 patients: A multi-centre retrospective study

Abstract

Aim: In this study, we aimed to investigate early predictors of critical illness and mortality in patients with coronavirus disease 2019 (COVID-19) based on clinical, biochemical, radiological, and epidemiological findings. Materials and Methods: This multi-center, retrospective study was conducted in three centers and included a total of 206 confirmed COVID-19 cases using reverse transcription-polymerase chain reaction (RT-PCR). Data of survivors and non-survivors were compared, and predictors of mortality were examined. Results: Among the patients, 103 (50%) were males with a mean age of 52.8±16.7 years;88.3% of the patients were discharged in a healthy condition, while 11.7% died. The mean age was significantly higher in non-survivors. Dyspnea occurred in 32.5% of patients, and a significant correlation was found between dyspnea and mortality (p<0.001). Thoracic computed tomography (CT) findings were positive in 88.8% of patients. The most frequent imaging findings were ground-glass opacities in 86.4% and consolidation in 33% of patients. The mortality rate was significantly higher in patients with comorbidities (p<0.001). There was also a significant correlation between lymphocytopenia and mortality (p<0.001). A positive correlation was found between mortality risk and platelet-to-lymphocyte, neutrophil-to-lymphocyte, and red cell distribution width indices. The mortality risk was significantly higher in patients with acute kidney injury (10.7%) (p<0.001). Discussion: These results suggest that advanced age, coexisting diabetes, hypertension, heart failure, chronic kidney disease, or acute kidney injury are associated with an increased mortality risk. The presence of dyspnoea or consolidation on thoracic CT can predict an increased mortality risk in COVID-19 patients.