BASELINE CHARACTERISTICS AND PREDICTORS FOR ALL-CAUSE MORTALITY IN PATIENTS HOSPITALIZED WITH COVID-19 PNEUMONIA

ABSTRACT

TOPIC Chest Infections TYPE Original Investigations PURPOSE: COVID Pneumonia is associated with high morbidity and mortality accounting for 3 million deaths worldwide. This aim of this study is to identify risk factors related to mortality in patients admitted to the hospital with COVID Pneumonia and to compare baseline characteristics and outcomes of different racial groups. METHODS: This is a retrospective observational study of patients 18 years and older who were admitted to an academic medical center between March to May of 2020. Categorical variables were reported as counts and percentages, using Chi Square or Exact Fischer test. Continuous variables were reported in means and standard deviation using Student T test. Logistic regression was performed to identify factors associated with mortality. RESULTS: 190 patients were included in the study, 157 (82.63%) were African American (AA). AA patients had significantly higher weight, BMI and creatinine on admission. Prevalence of chronic kidney disease (CKD) was significantly higher in AA patients while the prevalence of atrial fibrillation was higher in non-AA patients. There was no difference in all-cause mortality between non-AA and AA groups (27.27% VS 20.38%, p=0.38). Factors that were associated with all-cause mortality included underlying CVA (OR=2.84, p<0.01, CI (1.3, 6.22)), thrombocytopenia (OR=0.99, p<0.01, CI (0.98, 0.99)), acute kidney injury (OR=2.95, p<0.01, CI (1.45, 6)), elevated alkaline phosphatase (OR=1.006, p=0.035, CI (1.0004, 1.01)), elevated D dimer (OR=1.0003, p<0.01, CI (1.00008, 1.0006)), elevated CRP (OR=1.1, p<0.01, CI (1.04, 1.16)), acute respiratory distress syndrome (ARDS) (OR=11.17, p<0.01, CI (4.9, 25.46)), intubation (OR=22.56, p<0.01, CI (9.49, 53.66)), vasopressor requirement (OR=14.77, p<0.01, CI (6.36, 34.3)) and use of hydroxychloroquine (OR=25.37, p<0.01, CI (2.96, 217.55)). Multi-variable logistic regression was used to control for confounding and race was not associated with mortality (OR=0.25, p=0.21, CI (0.03,2.19)). CONCLUSIONS: In patients with COVID pneumonia, organ dysfunction and the use of Hydroxychloroquine were factors associated with increased mortality. Despite significant differences in baseline weight, BMI, prevalence of AF and CKD among AA and non-AA patients, there was no significant difference in mortality between the 2 groups. CLINICAL IMPLICATIONS Clinicians should consider early close monitoring of patients with COVID19 pneumonia and evidence of end organ dysfunction since there seems to be an association with increased mortality. Based on our retrospective study the use of hydroxychloroquine should be avoided in this patient population. DISCLOSURES No relevant relationships by Adekola Adedeji, source=Web Response No relevant relationships by Prangthip Charoenpong, source=Web Response No relevant relationships by Nour Daoud, source=Web Response No relevant relationships by Deon Ford, source=Web Response No relevant relationships by Nasim Motayar, source=Web Response No relevant relationships by Diana Song, source=Web Response