Comparative assessment of mortality risk factors between admission and follow-up models among patients hospitalized with COVID-19
Objectives: This study aimed to compare differences in mortality risk factors between admission andfollow-up incorporated models.Methods: A retrospective cohort study of 524 patients with confirmed COVID-19 infection admitted to atertiary medical center in São Paulo, Brazil from 13 March to 30 April...
| Main Authors: | Lazar Neto, Fellipe, Salzstein, Guilherme A., Cortez, André L., Bastos, Thaís L., Baptista, Fabíola V. D., Moreira, Joanne A., Lauterbach, Gerhard P., Oliveira, Julio Cesar de, Assis, Fábio Cavalcante, Aguiar, Marília R. A., Deus, Aline A. de, Dias, Marcos Felipe D. S., Sousa, Felipe C. B., Duailibi, Daniel F., Kondo, Rodrigo H., Moraes, Augusto César F. de, Martins, Milton A. |
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| Format: | Artigo |
| Language: | Inglês |
| Published: |
Elsevier Ltd on behalf of International Society for Infectious Diseases
2021
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| Subjects: | |
| Online Access: |
https://repositorio.unb.br/handle/10482/40490 https://doi.org/10.1016/j.ijid.2021.03.013 |
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| Summary: |
Objectives: This study aimed to compare differences in mortality risk factors between admission andfollow-up incorporated models.Methods: A retrospective cohort study of 524 patients with confirmed COVID-19 infection admitted to atertiary medical center in São Paulo, Brazil from 13 March to 30 April 2020. Data were collected onadmission, and the third, eighth and fourteenth days of hospitalization. The hazard ratio (HR) wascalculated and 28-day in-hospital mortality risk factors were compared between admission and follow-up models using a time-dependent Cox regression model.Results: Of 524 patients, 50.4% needed mechanical ventilation. The 28-day mortality rate was 32.8%.Compared with follow-up, admission models under-estimated the mortality HR for peripheral oxygensaturation <92% (1.21 versus 2.09), heart rate >100 bpm (1.19 versus 2.04), respiratory rate >24/min (1.01versus 1.82) and mechanical ventilation (1.92 versus 12.93). Low oxygen saturation, higher oxygensupport and more biomarkers–including lactate dehydrogenase, C-reactive protein, neutrophil-lymphocyte ratio, and urea remained associated with mortality after adjustment for clinical factorsat follow-up compared with only urea and oxygen support at admission.Conclusions: The inclusion of follow-up measurements changed mortality hazards of clinical signs andbiomarkers. Low oxygen saturation, higher oxygen support, lactate dehydrogenase, C-reactive protein,neutrophil-lymphocyte ratio, and urea could help with prognosis of patients during follow-up. |
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