Clinical Characteristics, Laboratory Findings, and Outcomes in Patients with Covid-19 Infection at a Community Hospital

ABSTRACT

SESSION TITLE Imaging Across the Care Spectrum SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/19/2022 1115 am - 1215 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