ABSTRACT
Aim: To date, limited data exists on 1-year mortality and associated factors in patients with coronavirus diseases-2019 (COVID-19). We determined risk factors and predictors of 1-year mortality. Method(s): In this retrospective and single-center study, hospitalized patients with COVID-19 were enrolled between March 11 and March 11, 2020. The primary outcome was 1-year all-cause mortality after discharge from the hospital. Secondary outcomes were the risk factors and predictors of 1-year mortality. A comparative analysis was applied to patients who died after recovering from acute COVID-19 and patients who survived. Result(s): A total of 567 patients were analyzed. The 1-year mortality occurred in 18 (3.2%) patients. Older age (p=0.001), chronic obstructive pulmonary disease (p=0.001), chronic artery disease (p=0.001), chronic renal failure (p=0.001), presence of pleural fluid (p=0.001), high levels of leukocyte (p=0.001), neutrophil (p=0.001), monocyte (p=0.026), C-reactive protein (p=0.042), procalcitonin (p=0.004), urea (p=0.001), creatinine (p=0.001), troponin (p=0.001), lactate dehydrogenase (p=0.019), potassium (p=0.003), and a low level of alanine aminotransferase (p=0.001) at the first admission were associated with increased long-term mortality. Additionally, the need for intensive care unit (ICU) admission (p=0.007) and invasive ventilation (p=0.019) during the hospital stay for COVID-19 were associated with increased 1-year mortality. Conclusion(s): This study suggests that age, underlying diseases, pleural fluid, certain laboratory parameters, and ICU care are somewhat associated with 1-year mortality. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.
ABSTRACT
Background. We aimed to explore a novel risk score to predict mortality in hospitalised patients with COVID-19 pneumonia. In additoon, we compared the accuracy of the novel risk score with CURB-65, qSOFA and NEWS2 scores. Methods. The study was conducted in hospitalised patients with laboratory and radiologically confirmed COVID-19 pneumonia between November 1, 2020 and November 30, 2020. In this retrospective multicenter study. independent predictors were identified using multivariate logistic regression analysis. A receiver operating characteristics (ROC) analysis with area under the curve (AUC) was used to evaluate the performance of the novel score. The optimal cut-off points of the candidate variables were calculated by the Youden's index of ROC curve. Mortality was defined as all cause in-hospital death. Results. A total of 1013 patients with COVID-19 were included. The mean age was 60,5 ±14,4 years, and 581 (57,4%) patients were male. In-hospital death was occured in 124 (12,2%) patients. Multivariate analysis revealed that peripheral capillary oxygen saturation (SpO2), albumin, D-dimer, and age were independent predictors for mortality (Table). A novel scoring model was named as SAD-60 (SpO2, Albumin, D-dimer, ≥60 years old). SAD-60 score (0,776) had the highest AUC compared to CURB-65 (0,753), NEWS2 (0,686), and qSOFA (0,628) scores (Figure). Conclusion. We demonstrated that SAD-60 score had a promising predictive capacity for mortality in hospitalised patients with COVID-19. Univariate and multivariate analysis of factors predicting mortality Comparison of CURB-65, qSOFA, NEWS-2 and SAD-60 for predicting pneumonia mortality in hospitalised patients with COVID-19 by ROC analysis.
ABSTRACT
NTRODUCTION: Anticoagulant treatment approach in patients with COVID-19 is not well studied and not standardized. We aimed to compare the effects of standard prophylactic and pre-emptive therapeutic Low-Molecular-weight Heparin (LMWH) treatment approaches on mortality in patients with COVID-19. PATIENTS AND METHODS: This retrospective and single-centre study includes patients aged ≥ 18 years, who were diagnosed with COVID-19 and treated with LMWH during the hospital stay. Therapeutic dose of LMWH was defined as 1 mg/kg subcutaneously twice daily and prophylactic dose of LMWH was defined as 40 mg subcutaneously once daily. RESULTS: Among the 336 patients diagnosed with COVID-19 pneumonia, 115 patients, who received LMWH were included in the study. The mean age was 58.6 ± 13.3 and 58 (50.4 %) of the patients were male. Sixty-nine (60 %) of the patients were treated with prophylactic and 46 (40 %) therapeutic LMWH.In-hospital mortality was not different between patients treated therapeutic LMWH and prophylactic LMWH by the multivariate regression analysis (OR=2.187, 95% CI 0.484-9.880, p=0.309) and the propensity score modelling (OR=1.586, 95% CI 0.400-6.289, p=0.512.)CONCLUSION: Clinicians should consider the potential risks and benefits of standard prophylactic and pre-emptive therapeutic LMWH. Therefore, anticoagulant therapy should be individualized in patients with COVID-19 (Tab. 3, Ref. 28).