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Predictors for cause-specific and timing of deaths in patients with COVID-19: a cohort study in Taiwan

Yen et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09654-w
Aug 2024  
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Mortality -103% Improvement Relative Risk Dexamethasone  Yen et al.  EARLY TREATMENT Is early treatment with dexamethasone beneficial for COVID-19? Retrospective 2,196 patients in Taiwan (January - July 2022) Higher mortality with dexamethasone (p=0.0002) c19early.org Yen et al., BMC Infectious Diseases, Aug 2024 Favorsdexamethasone Favorscontrol 0 0.5 1 1.5 2+
Retrospective 2,196 COVID-19 patients in Taiwan (49% mild cases, 44% moderate, 7% severe) showing significantly higher mortality with dexamethasone.
Authors report that all infected patients were hospitalized at the time of the study in Taiwan.
Study covers molnupiravir and paxlovid.
risk of death, 103.0% higher, HR 2.03, p < 0.001, treatment 572, control 1,624, adjusted per study, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yen et al., 20 Aug 2024, retrospective, Taiwan, peer-reviewed, 6 authors, study period 1 January, 2022 - 31 July, 2022. Contact: dxd41@tpech.gov.tw.
This PaperMiscellaneousAll
Predictors for cause-specific and timing of deaths in patients with COVID-19: a cohort study in Taiwan
Yung-Feng Yen, Shang-Yih Chan, Yun-Ju Lai, Muh-Yong Yen, Chu-Chieh Chen, Mei-Ju Chen
doi:10.1186/s12879-024-09654-w
Background This cohort study determines the predictors for cause-specific and timing of deaths in patients with COVID-19 in Taiwan. Methods Patients with laboratory-confirmed COVID-19 admitted to Taipei City Hospital from January 1 to July 31, 2022, were recruited in this cohort. All patients were followed up until death, discharge from the hospital, or August 31, 2022. Early deaths within the first 2 weeks were recorded, and the cause of death was confirmed by the death certificate database of Taiwan. Predictors of cause-specific and timing of deaths of patients with COVID-19 were determined using multinomial Cox proportional hazards regression analysis. Results Of the 195 (8.0%) patients who died during hospitalization, 147 (84.0%) had COVID-19-specific deaths. Moreover, 54.9% of the deceased patients had early death. After controlling for other covariates, patients aged ≥ 65 years had a higher risk of COVID-19-specific, non-COVID-19-specific, early, and late deaths [adjusted hazards ratio (AHR): 3.85, 6.45, 3.33, and 6.57; 95% confidence interval (CI): 1. 91-7.78, 1.17-35.68, 1.51-7.36, and 2.18-19.76, respectively]. Fully vaccinated patients had a lower risk of COVID-19-specific (AHR: 0.68; 95% CI: 0.47-0.98) and early deaths (AHR: 0.54; 95% CI: 0.35-0.84), whereas comorbid patients with chronic obstructive pulmonary disease had a higher risk of non-COVID-19-specific deaths (AHR: 5.43; 95% CI: 1.73-17.03). Conclusions This study suggests that prioritizing COVID-19 vaccination and carefully monitoring comorbid patients during hospitalization can reduce the risk of COVID-19-specific and early deaths and non-COVID-19-specific mortalities, respectively.
Abbreviations Declarations Ethics approval and consent to participate This study was approved by the Institutional Review Board of Taipei City Hospital (no. TCHIRB-10904014-E). Formal consent is waived for this type of study. Consent for publication Not Applicable. Competing interests The authors declare no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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