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Predictors of Mortality among inpatients with COVID-19 Infection in a Tertiary Referral Center in the Philippines

Malundo et al., IJID Regions, doi:10.1016/j.ijregi.2022.07.009
Jul 2022  
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Mortality -17% Improvement Relative Risk Remdesivir  Malundo et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 1,215 patients in Philippines (Mar - Sep 2021) Higher mortality with remdesivir (not stat. sig., p=0.45) c19early.org Malundo et al., IJID Regions, July 2022 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 1,215 hospitalized patients in the Phillipines, showing no significant difference in outcomes with remdesivir or HCQ use in unadjusted results subject to confounding by indication.
Gérard, Zhou, Wu, Kamo, Choi show significantly increased risk of acute kidney injury with remdesivir.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
Study covers remdesivir and HCQ.
risk of death, 16.5% higher, RR 1.17, p = 0.45, treatment 24 of 115 (20.9%), control 197 of 1,100 (17.9%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Malundo et al., 14 Jul 2022, retrospective, Philippines, peer-reviewed, 16 authors, study period 12 March, 2021 - 9 September, 2021. Contact: agmalundo@up.edu.ph, annaflormalundo@gmail.com.
This PaperRemdesivirAll
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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Late treatment
is less effective
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