ABSTRACT
SESSION TITLE: Imaging Across the Care Spectrum SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Mortality from coronavirus disease 2019 (COVID-19) has been associated with multiple risk factors. Despite this, prediction of illness trajectory remains difficult. We conducted a retrospective, exploratory case control study to determine risk factors for death among COVID-19 hospitalized patients in our local patient population. METHOD(S): Data was ed from 03/01 to 05/31/2020. Study population included hospitalized COVID-19 patients. We reviewed their demographics, past medical history, symptoms, oxygen requirements, BMI, imaging, laboratory markers, admission location, length of stay, requirement of CRRT/HD, final outcome. We compared those who died to those who survived to discharge. Mortality rates within individual risk factors were analyzed using an independent t-Test of percentages. The percentages were compared across the most common risk factors and tested for statistical significance with Chi square analysis at p< 0.05. RESULT(S): There were 281 patients admitted with COVID-19, 48 of them died. There was a significant increased risk of death with age (p<0.0001, OR=1.07;CI=1.05-1.1);history of obstructive sleep apnea (p=0.03), CKD/ESRD (p=0.01), CAD (p=0.02);presenting symptoms of dyspnea (p=0.04), respiratory rate (p=0.0002, OR=1.07;CI=1.03-1.12);absolute lymphopenia (p=0.03);LDH (p<0.0001, OR = 1.00;CI=1.001-1.004);AST (p=0.03);CRP (p=0.003, OR = 1.00;CI=1.00-1.01);on initial presentation, requiring non-rebreather (p<0.0001, OR 3.60;CI 95%, 1.73-7.50), BiPAP (p=0.004, OR 4.592;CI 95%, 1.47-14.34), invasive ventilation (p< 0.0001, OR 7.36;CI 95%, 2.73-19.85);imaging findings of bilateral infiltrates/consolidation (p=0.04);CRRT/HD (p< 0.0001, OR 6.78;CI 95%, 2.69-17.12);admission to ICU (p-< 0.0001, OR 3.52CI 95%, 1.82-6.81);transfer to ICU (p<0.0001, OR 3.62CI 95%, 1.81-7.22). There was no significant association between death and sex, hypertension, diabetes, CHF, COPD, asthma, obesity, length of stay, fever, cough, fatigue, GI symptoms, D-Dimer, Ferritin, Fibrinogen, PaO2/FiO2 ratio, and requiring nasal cannula on presentation. CONCLUSION(S): We identified a range of patient characteristics, comorbidities, symptoms, and laboratory markers that are suggestive of an increased risk of mortality from COVID-19. There were some factors that differed but did not reach statistical significance. A larger sample size is needed to resolve this. Interestingly, we identified obesity to have a protective trend with a relative 30% lower death rate, and a larger sample size could make this significant, suggesting a possible obesity paradox. However, many experts argue against this, citing that obesity is a detrimental risk factor and these patients need aggressive monitoring and treatment. CLINICAL IMPLICATIONS: Although COVID-19 mortality is associated with multiple risk factors, a physician's clinical judgment is still imperative in triaging which patients are at increased risk of death. DISCLOSURES: No relevant relationships by Mohamed Ghiath Bayasi No relevant relationships by Alan Bridgmon No relevant relationships by Kristen Hartnett No relevant relationships by Bineh-Karan Kalra No relevant relationships by Joanna Wieckowska No relevant relationships by Elise Wojcik Copyright © 2022 American College of Chest Physicians