Comparative assessment of mortality risk factors between admission and follow-up models among patients hospitalized with COVID-19

International Journal of Infectious Diseases

卷:105

Guilherme A. Salzstein¹  Aline A. de Deus²  Thaís L. Bastos³  Marília R.A. Aguiar⁴  Fábio C. de Assis⁴  Felippe Lazar Neto⁴  Marcos Felipe D.S. Dias⁴  Daniel F. Duailibi⁴  Gerhard P. Lauterbach⁴  Milton A. Martins⁴  Fabíola V.D. Baptista⁴  Augusto César F. de Moraes⁴  Felipe C.B. Sousa⁴  Rodrigo H. Kondo⁴  André L. Cortez⁴  Julio Cesar de Oliveira⁴  Joanne A. Moreira⁴ 

[1] Corresponding author at: Av. Dr. Eneas Carvalho de Aguiar, 155, Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brazil.;

[2] Department of Emergency and Internal Medicine, Universidade de Brasília (UnB), Brazil;

[3] Department of Infectious Diseases, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brazil;

[4] Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brazil;

关键词: COVID-19;    Coronavirus;    Follow-up;    Mortality;    Brazil;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: This study aimed to compare differences in mortality risk factors between admission and follow-up incorporated models. Methods: A retrospective cohort study of 524 patients with confirmed COVID-19 infection admitted to a tertiary medical center in São Paulo, Brazil from 13 March to 30 April 2020. Data were collected on admission, and the third, eighth and fourteenth days of hospitalization. The hazard ratio (HR) was calculated and 28-day in-hospital mortality risk factors were compared between admission and follow-up models using a time-dependent Cox regression model. Results: Of 524 patients, 50.4% needed mechanical ventilation. The 28-day mortality rate was 32.8%. Compared with follow-up, admission models under-estimated the mortality HR for peripheral oxygen saturation <92% (1.21 versus 2.09), heart rate >100 bpm (1.19 versus 2.04), respiratory rate >24/min (1.01 versus 1.82) and mechanical ventilation (1.92 versus 12.93). Low oxygen saturation, higher oxygen support and more biomarkers–including lactate dehydrogenase, C-reactive protein, neutrophil-lymphocyte ratio, and urea remained associated with mortality after adjustment for clinical factors at follow-up compared with only urea and oxygen support at admission. Conclusions: The inclusion of follow-up measurements changed mortality hazards of clinical signs and biomarkers. Low oxygen saturation, higher oxygen support, lactate dehydrogenase, C-reactive protein, neutrophil-lymphocyte ratio, and urea could help with prognosis of patients during follow-up.

【 授权许可】

Unknown