Predictors of Mortality among Hospitalized Patients with COVID-19 in Egypt-A Retrospective Observational Study
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The prediction of mortality and risk stratification of severe coronavirus disease 2019 (Covid-19) offers a rational approach for clinical support, health resource allocation, and implementation of protective interventions to optimize the treatment. Clinicians need these predictors that permit them to elderly patients with Covid-19 rapidly during the pandemic. Investigate demographic features, clinical characteristics, laboratory parameters, and pharmacological treatment received by individuals who died due to Covid-19 that may be predictors of mortality. A retrospective observational study. A single-center cohort in Almaza Fever Egyptian Hospital through three years of the pandemic, 2020, 2021, and 2022. About 194 elderly patients with Covid-19 were attendees of the hospital and died through three years of the pandemic, 2020, 2021, and 2022. A total of 64 cases were in 2020, 94 cases in 2021, and 36 cases in 2022. Main outcome measures: Mortality after a short stay of 9 days evaluated by the area under the curve (AUC), determination of the clinical features, and laboratory measures that may be predictors related to mortality over the three years of the pandemic. Our research found a statistically significant variation between the three years (2020, 2021, and 2022) regarding co-morbidities including IHD, renal and stroke (p-value < 0.05), treatment including Iverzine, chloroquine, remedisvir, and SL (P-value < 0.001), and symptoms including pneumonia status, cytokine storm, dyspnea, cough, anosmia, loss of taste and GIT symptoms (p-value < 0.005). After analysis, there were some predictors, including male sex, age, and hospital stay, that were positively associated with the deterioration of some laboratory measures and biomarkers such as IL-6 with mortality after a short period of stay (9 days) over time. The presented study showed a reliable prediction of mortality over time, so, it plays a crucial role in early patients' identification who are at high risk of death. Therefore, the deteriorated cases should be closely monitored.
Zhu, N. et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 2020;382.
Alharbi, Y., Alqahtani, A., Albalawi, O. & Bakouri, M. Epidemiological modeling of COVID-19 in Saudi Arabia: Spread projection, awareness, and impact of treatment. Appl. Sci. 2020;10.
Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506.
Guan, W. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N. Engl. J. Med. 2020;382:1708–1720.
Alharthy, A. et al. Clinical characteristics and predictors of 28-day mortality in 352 critically ill patients with COVID-19: A retrospective study. J. Epidemiol. Glob. Health 2021;11.
Esfahanian, F., SeyedAlinaghi, S., Janfaza, N. & Tantuoyir, M. M. Predictors of hospital mortality among patients with COVID-19 in Tehran, Iran. SAGE Open Med. 2021;9.
Roser, M., Ritchie, H., Ortiz-Ospina, E. & Hasell, J. Coronavirus disease (COVID-19)–Statistics and research. Our World data 2020.
Chen, N. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395.
Wang, D. et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA - J. Am. Med. Assoc. 2020;323.
Park, M. et al. Determining the communicable period of SARS-CoV-2: A rapid review of the literature, March to September 2020. Eurosurveillance vol. 26 2021. https://doi.org/10.2807/1560-7917.ES.2021.26.14.2001506.
Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395.
Docherty, A. et al. Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol. medRxiv 2020.
Liang, W. et al. Development and validation of a clinical risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. JAMA Intern. Med. 2020;180.
Knight, S. R. et al. Risk stratification of patients admitted to hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: Development and validation of the 4C Mortality Score. BMJ 2020;370.
et al. Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020. (The Lancet, (S0140673620305663), (101016/S0140-6736(20)30566-3)).
Chauhan, N. K. et al. Predictors of clinical outcomes in adult COVID-19 patients admitted to a tertiary care hospital in India: An analytical cross-sectional study. Acta Biomed. Lancet 2021;92.
Salunke, A. A. et al. A proposed ABCD scoring system for patient’s self assessment and at emergency department with symptoms of COVID-19. Diabetes and Metabolic Syndrome: Clinical Research and Reviews vol. 14 2020. https://doi.org/10.1016/j.dsx.2020.07.053.
Rizo-Téllez, S. A. et al. The neutrophil-to-monocyte ratio and lymphocyte-to-neutrophil ratio at admission predict in-hospital mortality in mexican patients with severe sars-cov-2 infection (Covid-19). Microorganisms. 2020;8.
Zhou, F. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395.
Berenguer, J. et al. Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain. Clin. Microbiol. Infect. 2020;26.
Kim, L. et al. Risk Factors for Intensive Care Unit Admission and In-hospital Mortality among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Clin. Infect. Dis. 2021;72.
Honing, M. L. H., Morrison, P. J., Banga, J. D., Stroes, E. S. G. & Rabelink, T. J. Nitric oxide availability in diabetes mellitus. Diabetes/Metabolism Reviews vol. 14 1998. https://doi.org/10.1002/(SICI)1099-0895(1998090)14:3<241::AID-DMR216>3.0.CO;2-R.
Hermann, M., Flammer, A. & Lüscher, T. F. Nitric oxide in hypertension. Journal of clinical hypertension (Greenwich, Conn.) vol. 8 2006. https://doi.org/10.1111/j.1524-6175.2006.06032.x.
Mehraeen, E. et al. Predictors of mortality in patients with COVID-19–a systematic review. European Journal of Integrative Medicine vol. 40 2020. https://doi.org/10.1016/j.eujim.2020.101226.
Chomistek, A. K. et al. Predictors of critical care, mechanical ventilation, and mortality among hospitalized patients with COVID-19 in an electronic health record database. BMC Infect. Dis. 2022;22.
COVID-19 Treatment Guidelines. https://www.covid19treatmentguidelines.nih.gov/.
Alkundi, A., Mahmoud, I., Musa, A., Naveed, S. & Alshawwaf, M. Clinical characteristics and outcomes of COVID-19 hospitalized patients with diabetes in the United Kingdom: A retrospective single-center study. Diabetes Res. Clin. Pract. 2020;165.
Moledina, S. M. et al. Clinical characteristics and predictors of mortality in patients with COVID-19 infection outside intensive care. Int. J. Gen. Med. 2020;13.
The Sex, Gender and COVID-19 Project | Global Health 50/50. https://globalhealth5050.org/the-sex-gender-and-covid-19-project/.
Griffith, D. M. et al. Men and COVID-19: A biopsychosocial approach to understanding sex differences in mortality and recommendations for practice and policy interventions. Preventing Chronic Disease vol. 17 2020. https://doi.org/10.5888/PCD17.200247.
Albalawi, O. et al. Clinical characteristics and predictors of mortality among COVID-19 patients in Saudi Arabia. J. Infect. Public Health 2021;14.
Tian, W. et al. Predictors of mortality in hospitalized COVID-19 patients: A systematic review and meta-analysis. Journal of Medical Virology vol. 92 2020. https://doi.org/10.1002/jmv.26050.
Tang, N., Li, D., Wang, X. & Sun, Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J. Thromb. Haemost. 2020;18.
Copyright (c) 2024 Mohamed Abdel-Salam Elgohary, Mostafa Mahmoud Elnakib, Mohamed G Seadawy, Mohamed Emam Mohamed5, dina elaraby, Amany Ahmad Ibrahim, Osama Hasan Bekheet, Ashraf Ibrahim Zaki, Mahmoud Zeinhom Abdelfattah, Hesham Mosaad Sheshtawy, Marina Raouf Abdelmessih Saleeb, Nouran Ameen Hamza, Nashwa Naguib Omar, Ahmed Mahmoud ElShafei , Jacklin Samir kamal6
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