Jian Li1, Luyu Yang2, Qian Zeng3, Qingyun Li4, Zhitao Yang5, Lizhong Han6, Xiaodong Huang7, Erzhen Chen8. 1. Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of ICU/Emergency, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China. 3. Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 4. Department of Respiration and Critical Care Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 5. Emergency Department, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 6. Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 13916291150@163.com. 7. Department of Gastroenterology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China. hxd19681031@whu.edu.cn. 8. Emergency Department, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. chen_ez@163.com.
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) has resulted in an overwhelmed challenge to the healthcare system worldwide. METHODS: A case-control study of COVID-19 patients in Wuhan Third Hospital was conducted. 96 deceased COVID-19 patients and 230 discharged patients were included as the case group and control group, respectively. Demographic, epidemiological, clinical and laboratory variables on admission were collected from electronic medical records. Univariate and multivariate logistic regression were adopted to investigate the independent predictors of mortality. A nomogram was formed for predicting the mortality risk. RESULTS: The multivariate stepwise logistic model demonstrated that age of 60+ years (OR =4.426, 95% CI: 1.955-10.019), comorbidity of cerebrovascular disease (OR =7.084, 95% CI: 1.545-32.471), white blood cell (WBC) count >9.5×109 /L (OR =7.308, 95% CI: 1.650-32.358), platelet count <125×109/L (OR =5.128, 95% CI: 2.157-12.191), aspartate aminotransferase (AST) >40 U/L (OR =2.554, 95% CI: 1.253-5.206), cystatin C >1.1 mg/L (OR =4.132, 95% CI: 2.118-8.059), C reactive protein (CRP) ≥100 mg/L (OR =2.830, 95% CI: 1.311-6.109), creatine kinase isoenzymes (CK-MB) >24 U/L (OR =6.015, 95% CI: 2.119-17.07) and D-dimer >5 μg/L (OR =4.917, 95% CI: 1.619-14.933) were independent predictors of mortality of COVID-19 patients. The nomogram demonstrated a well discriminatory accuracy for mortality prediction with a C-index of 0.903. CONCLUSIONS: The determinants identified may help to determine patients at high risk of death at an early stage and guide the optimal treatment.
BACKGROUND:Coronavirus disease 2019 (COVID-19) has resulted in an overwhelmed challenge to the healthcare system worldwide. METHODS: A case-control study of COVID-19patients in Wuhan Third Hospital was conducted. 96 deceased COVID-19patients and 230 discharged patients were included as the case group and control group, respectively. Demographic, epidemiological, clinical and laboratory variables on admission were collected from electronic medical records. Univariate and multivariate logistic regression were adopted to investigate the independent predictors of mortality. A nomogram was formed for predicting the mortality risk. RESULTS: The multivariate stepwise logistic model demonstrated that age of 60+ years (OR =4.426, 95% CI: 1.955-10.019), comorbidity of cerebrovascular disease (OR =7.084, 95% CI: 1.545-32.471), white blood cell (WBC) count >9.5×109 /L (OR =7.308, 95% CI: 1.650-32.358), platelet count <125×109/L (OR =5.128, 95% CI: 2.157-12.191), aspartate aminotransferase (AST) >40 U/L (OR =2.554, 95% CI: 1.253-5.206), cystatin C >1.1 mg/L (OR =4.132, 95% CI: 2.118-8.059), C reactive protein (CRP) ≥100 mg/L (OR =2.830, 95% CI: 1.311-6.109), creatine kinase isoenzymes (CK-MB) >24 U/L (OR =6.015, 95% CI: 2.119-17.07) and D-dimer >5 μg/L (OR =4.917, 95% CI: 1.619-14.933) were independent predictors of mortality of COVID-19patients. The nomogram demonstrated a well discriminatory accuracy for mortality prediction with a C-index of 0.903. CONCLUSIONS: The determinants identified may help to determine patients at high risk of death at an early stage and guide the optimal treatment.
Entities:
Keywords:
Coronavirus disease 2019 (COVID-19); case control study; determinant; mortality