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head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2024, vol. 30, issue1
Subject Area: Medicine
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DOI: 10.5272/jimab.2024301.5369
Published online: 14 February 2024

Original article
J of IMAB. 2024 Jan-Mar;30(1):5369-5374
RISK FACTORS ASSOCIATED WITH IN-HOSPITAL MORTALITY IN PATIENT WITH SEVERE COVID-19 INFECTION
Ralitsa PanchevaORCID logo, Ventsislava PenchevaORCID logo, Emil ManovORCID logo, Blagovest StoimenovORCID logoCorresponding Autoremail,
Department of Propaedeutics of Internal Diseases, UMHAT "Alexandrovska", Medical Faculty, Medical University – Sofia, Bulgaria.

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.

Keywords: COVID-19, mortality, complications,

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Please cite this article as: Pancheva R, Pencheva V, Manov E, Stoimenov B. Risk Factors Associated with In-Hospital Mortality in patient with severe COVID-19 infection. J of IMAB. 2024 Jan-Mar;30(1):5369-5374. [Crossref - 10.5272/jimab.2024301.5369]

Corresponding AutorCorrespondence to: Blagovest Stoimenov, Department of propaedeutics of internal diseases, UMHAT "Alexandrovska"; Medical Faculty, Medical University – Sofia; 1, St. Georgi Sofiiski Str., Sofia, Bulgaria; E-mail: stoimenov90@gmail.com

REFERENCES:
1. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020 May;8(5):475-481. [PubMed ]
2. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 50 patients from Wuhan, China. Intensive Care Med. 2020 May;46(5):846-848. [PubMed]
3. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. [PubMed]
4. Peng YD, Meng K, Guan HQ, Leng L, Zhu RR, Wang BY, et al. [Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV]. [in Chinese] Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Jun 24;48(6):450-455. [PubMed]
5. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020 Mar 26;368:m1091. [PubMed]
6. Inciardi RM, Adamo M, Lupi L, Cani DS, Di Pasquale M, Tomasoni D, et al. Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. Eur Heart J. 2020 May 14;41(19):1821-1829. [PubMed]
7. Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020 May;109(5):531-538. [PubMed]
8. Rocco IS, Gomes WJ, Viceconte M, Bolzan DW, Moreira RSL, Arena R, et al. Cardiovascular involvement in COVID-19: not to be missed. Braz J Cardiovasc Surg. 2020 Aug 1;35(4):530-538. [PubMed]
9. Richardson S, Hirsch JS, Narasimhan M,  Crawford J, McGinn T, Davidson K, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020 May 29;323:2052-9. [PubMed]
10. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with sars-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA. 2020 Apr 28;323(16):1574–81. [PubMed]
11. Cates J, Lucero-Obusan C, Dahl RM, Schirmer P, Garg S, Oda G, et al. Risk for In-Hospital Complications Associated with COVID-19 and Influenza - Veterans Health Administration, United States, October 1, 2018-May 31, 2020. MMWR Morb Mortal Wkly Rep. 2020 Oct 23;69(42):1528-1534. [PubMed]
12. Bartleson JM, Radenkovic D, Covarrubias AJ, Furman D, Winer DA, Verdin E. SARS-CoV-2, COVID-19 and the Ageing Immune System. Nat Aging. 2021 Sep;1(9):769-782. [PubMed]
13. Li MY, Li L, Zhang Y, Wang XS. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 2020 Apr 28;9(1):45. [PubMed]
14. Cantuti-Castelvetri L, Ojha R, Pedro LD, Djannatian M, Franz J, Kuivanen S, et al. Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity. Science. 2020 Nov 13;370(6518):856-860. [PubMed]
15. Wang K, Chen W, Zhang Z, Deng Y, Lian JQ, Du P, et al. CD147-spike protein is a novel route for SARS-CoV-2 infection to host cells. Signal Transduct Target Ther. 2020 Dec 4;5(1):283. [PubMed]
16. Chen X, Yan L, Fei Y, Zhang C. Laboratory abnormalities and risk factors associated with in-hospital death in patients with severe COVID-19. J Clin Lab Anal. 2020 Oct;34(10):e23467.  [PubMed]
17. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020 May 2;395(10234):1417-1418. [PubMed]
18. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al.. Comorbidity and its impact on 1590 patients with covid-19 in China: a nationwide analysis. Eur Respir J. 2020 May 14;55(5):2000547. [PubMed]
19. Parra-Bracamonte GM, Lopez-Villalobos N, Parra-Bracamonte FE. Clinical characteristics and risk factors for mortality of patients with COVID-19 in a large data set from Mexico. Ann Epidemiol. 2020 Dec:52:93-98.e2. [PubMed]
20. OVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Nov 11, 2021. [Internet]
21. Alshukry A, Bu Abbas M, Ali Y, Alahmad B, Al-Shammari AA, Alhamar G, et al. Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait. Heliyon. 2021 Apr 1;7(4):e06706. [PubMed]
22. Clark A, Jit M, Warren-Gash C, Guthrie B, Wang HHX, Mercer SW, et al. Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: A modelling study. Lancet Glob Health. 2020 Aug;8(8):e1003-e1017. . [PubMed]
23. Holman N, Knighton P, Kar P, O'Keefe J, Curley M, Weaver A, et al. Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: A population-based cohort study. Lancet Diabetes Endocrinol. 2020 Oct;8(10):823-833. [PubMed]
24. Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR, et al. Clinical impact of COVID-19 on patients with cancer (CCC19): A cohort study. Lancet. 2020 Jun 20;395(10241):1907-1918. [PubMed]
25. Rentsch CT, Kidwai-Khan F, Tate JP, Park LS, King JT Jr, Skanderson M, et al. Covid-19 by race and ethnicity: A national cohort study of 6 million United States veterans. medRxiv. 2020 May 18:2020.05.12.20099135. [PubMed]
26. Kruglikov IL, Scherer PE. The Role of Adipocytes and Adipocyte-Like Cells in the Severity of COVID-19 Infections. Obesity (Silver Spring). 2020 Jul;28(7):1187-1190. [PubMed]
27.  Chen L, Yu J, He W, Chen L, Yuan G, Dong F, et al. Risk factors for death in 1859 subjects with COVID-19. Leukemia. 2020 Aug;34(8):2173-2183. [PubMed]

Received: 16 October 2023
Published online: 14 February 2024

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