Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia
Basheer et al.
, Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia
, Metabolites, doi:10.3390/metabo11100679
Retrospective 390 hospitalized patients in Israel, showing higher risk of mortality with prior aspirin use. Details of the analysis are not provided.
risk of death, 13.0% higher, RR 1.13, p < 0.001, treatment 45 of 140 (32.1%), control 29 of 250 (11.6%), adjusted per study, odds ratio converted to relative risk, group sizes approximated (only percentages provided).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Basheer et al., 2 Oct 2021, retrospective, Israel, peer-reviewed, 4 authors.
Clinical Predictors of Mortality and Critical Illness in Patients
with COVID-19 Pneumonia
Maamoun Basheer 1,*, Elias Saad 1,2,*, Rechnitzer Hagai 3 and Nimer Assy 1,2,*
Internal Medicine Department, Galilee Medical Center, Nahariya 2210001, Israel
The Azrieli Faculty of Medicine, Bar-Ilan University, Safad 1311502, Israel
3 The Microbiology Lab, Galilee Medical Center, Nahariya 2210001, Israel; HagaiR@gmc.gov.il
* Correspondence: firstname.lastname@example.org (M.B.); email@example.com (E.S.); firstname.lastname@example.org (N.A.)
Abstract: Background/Aim: Early identification of patients with COVID-19 who will develop severe or critical
Citation: Basheer, M.; Saad, E.;
Hagai, R.; Assy, N. Clinical Predictors of Mortality and Critical Illness
in Patients with COVID-19 Pneumonia. Metabolites 2021, 11, 679.
disease symptoms is important for delivering proper and early treatment. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings that may be
of utility to clinicians in predicting COVID-19 severity and mortality. Methods: Electronic medical
record data from patients diagnosed with COVID-19 from November 2020 to June 2021 in the
COVID-19 Department in the Galilee Medical Center, Nahariya, Israel, were collected. Epidemiologic, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression
analyses and discriminant analyses were used to identify and validate powerful predictors. The
main outcome measure was invasive ventilation, or death. Results: The study population included
390 patients, with a mean age of 61 ± 18, and 51% were male. The non-survivors were mostly male,
elderly and overweight and significantly suffered from hypertension, diabetes mellitus type 2, lung
disease, hemodialysis and past use of aspirin. Four predictive factors were found that associated
with increased disease severity and/or mortality: age, NLR, BUN, and use of high flow oxygen therapy (HFNC). The AUC or diagnostic accuracy was 87%, with a sensitivity of 97%, specificity of 60%,
PPV of 87% and NPP of 91%. The cytokine levels of CXCL-10, GCSF, IL-2 and IL-6 were significantly
reduced upon the discharge of severely ill COVID-19 patients. Conclusions: The predictive factors
associated with increased mortality include age, NLR, BUN, and use of HFNC upon admission.
Identifying those with higher risks of mortality could help in early interventions to reduce the risk
Academic Editor: Amedeo Lonardo
Keywords: SARS-COV-2; NLR; high flow; BUN; insulin resistance; mortality; cytokine storm; predictors
Received: 20 September 2021
Accepted: 30 September 2021
Published: 2 October 2021
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Highlights: 1. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings. 2. The following four predictive factors were found
that were associated with increased disease severity and/or mortality: age, NLR, BUN,
and use of high flow oxygen therapy. 3. The AUC or diagnostic accuracy was 87%, with
a sensitivity of 97. 4. Identifying those with higher risks of mortality could help in early
interventions to reduce the risk of death.
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