RISK FACTORS ASSOCIATED WITH IN-HOSPITAL MORTALITY IN PATIENT WITH SEVERE COVID-19 INFECTION

Abstract

Background: Coronavirus disease (COVID-19) is a pandemic disease, infecting more than 673 million people. Accurate prediction of the risk of progression of COVID-19 is needed at the time of hospitalization. Material and Methods: A retrospective study was conducted between December, 2020 and December, 2021. A total of 165 patients admitted with severe COVID-19 infection were enrolled. The data were collected from the electronic medical records of Alexandrovska Hospital. Results: The mean age of the patients was 64.6±15, of whom 44.8% were men. The median duration from symptom onset to hospitalization was 8.2 days, and from symptom onset to discharge or death was 24.00 days respectively. In-hospital mortality was 23.3%, and post-discharge one-year mortality was 3.7%. 27 (16.7%) patients received invasive mechanical ventilation, 37 (23%) were admitted to the ICU, and 26 (15.8%) received vasopressors. Common acute complications among inpatients included acute pulmonary embolism (2.6%), acute stroke (0.6%), and minor bleeding (3.7%). 12 patients (7.7%) who survived COVID-19 hospitalization were readmitted for additional treatment of other diseases. Several laboratory markers were linked with increased in-hospital mortality: GFR < 55 ml/min, ferritin > 705 µg/L, PaO2 < 7.93 kPa; SpO2 < 93%, oxygen requirements > 12.5 l/min. Mortality risk was higher in patients having hypertension, coronary artery disease, previous ischemic stroke, valvular heart disease, chronic heart failure and atrial fibrillation. Conclusion: The mortality rate was higher in older patients with cardiovascular comorbidities and reduced renal function. Early recognition of high-risk patients may help to improve care and reduce mortality.