Predictors of mortality among inpatients with COVID-19 infection in a tertiary referral center in the Philippines
Anna Flor G Malundo, Cybele Lara R Abad, Maria Sonia S Salamat, Joanne Carmela M Sandejas, Jonnel B Poblete, Jose Eladio G Planta, Shayne Julieane L Morales, Ron Rafael W Gabunada, Agnes Lorrainne M Evasan, Johanna Patricia A Cañal, Julian A Santos, Jeffrey T Manto, Maria Elizabeth P Mercado, Raniv D Rojo, Eric David B Ornos, Marissa M Alejandria
IJID Regions, doi:10.1016/j.ijregi.2022.07.009
Objectives: The aim of this study was to determine the predictors of mortality and describe laboratory trends among adults with confirmed COVID-19. Methods: The medical records of adult patients admitted to a referral hospital with COVID-19 were retrospectively reviewed. Demographic and clinical characteristics, and laboratory parameters, were compared between survivors and non-survivors. Predictors of mortality were determined by multivariate analysis. Mean laboratory values were plotted across illness duration. Results: Of 1215 patients, 203 (16.7%) had mild, 488 (40.2%) moderate, 183 (15.1%) severe, and 341 (28.1%) critical COVID-19 on admission. In-hospital mortality was 18.2% (0% mild, 6.1% moderate, 15.8% severe, 47.5% critical). Predictors of mortality were age ≥ 60 years, COPD, qSOFA score ≥ 2, WBC > 10 × 10 9 /L, absolute lymphocyte count < 1000, neutrophil ≥ 70%, PaO 2 /FiO 2 ratio ≤ 200, eGFR < 90 mL/min/1.73 m 2 , LDH > 600 U/L, and CRP > 12 mg/L. Non-survivors exhibited an increase in LDH and decreases in PaO 2 /FiO 2 ratio and eGFR during the 2nd-3rd week of illness.
Conclusion: The overall mortality rate was high. Predictors of mortality were similar to those of other reports globally. Marked inflammation and worsening pulmonary and renal function were evident among non-survivors by the 2nd-3rd week of illness.
AUTHOR CONTRIBUTIONS Conceptualization/investigation -all authors; data collection -AGM, JMS, JBP, JGP, SLM, RWG, AME, JAC, JAS, JTM; data validation -AGM, JMS; data analysis -AGM, CRA, MSS, MMA, MPM; resources/software -AGM, MPM; supervision -MMA, MSS, CRA, JAC; writing, original draft -AGM, JBP, RWG, RDR, EBO; writing, review and editing -AGM, CRA, MSS, MMA.
ETHICAL APPROVAL The study was conducted with regulatory approval by the Institutional Review Board of UP-Manila.
Declaration of Competing Interest The authors declare no conflicts of interest.
Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi: 10.1016/j.ijregi.2022.07.009 .
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