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Determinants of mortality of patients with COVID-19 in Wuhan, China: a case-control study

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机构: [1]Shanghai Jiao Tong Univ, Ruijin Hosp, Clin Res Ctr, Sch Med, Shanghai, Peoples R China [2]Wuhan Univ, Wuhan Hosp 3, Dept ICU Emergency, Tongren Hosp, Wuhan, Peoples R China [3]Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Lab Med, Shanghai, Peoples R China [4]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Clin Microbiol, Sch Med, Shanghai, Peoples R China [5]Shanghai Jiao Tong Univ, Dept Resp & Crit Care Dis, Sch Med, Shanghai, Peoples R China [6]Shanghai Jiao Tong Univ, Ruijin Hosp, Emergency Dept, Sch Med, Shanghai, Peoples R China [7]Wuhan Univ, Wuhan Hosp 3, Dept Gastroenterol, Tongren Hosp, Wuhan, Peoples R China
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关键词: Coronavirus disease 2019 (COVID-19) mortality determinant case control study

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Background: Coronavirus disease 2019 (COVID-19) has resulted in an overwhelmed challenge to the healthcare system worldwide. Methods: A case-control study of COVID-19 patients in Wuhan Third Hospital was conducted. 96 deceased COVID-19 patients and 230 discharged patients were included as the case group and control group, respectively. Demographic, epidemiological, clinical and laboratory variables on admission were collected from electronic medical records. Univariate and multivariate logistic regression were adopted to investigate the independent predictors of mortality. A nomogram was formed for predicting the mortality risk. Results: The multivariate stepwise logistic model demonstrated that age of 60+ years (OR =4.426, 95% CI: 1.955-10.019), comorbidity of cerebrovascular disease (OR =7.084, 95% CI: 1.545-32.471), white blood cell (WBC) count >9.5x10(9)/L (OR =7.308, 95% CI: 1.650-32.358), platelet count <125x10(9)/L (OR =5.128, 95% CI: 2.157-12.191), aspartate aminotransferase (AST) >40 U/L (OR =2.554, 95% CI: 1.253-5.206), cystatin C >1.1 mg/L (OR =4.132, 95% CI: 2.118-8.059), C reactive protein (CRP) =100 mg/L (OR =2.830, 95% CI: 1.311-6.109), creatine kinase isoenzymes (CK-MB) >24 U/L (OR =6.015, 95% CI: 2.119-17.07) and D-dimer >5 mu g/L (OR =4.917, 95% CI: 1.619-14.933) were independent predictors of mortality of COVID-19 patients. The nomogram demonstrated a well discriminatory accuracy for mortality prediction with a C-index of 0.903. Conclusions: The determinants identified may help to determine patients at high risk of death at an early stage and guide the optimal treatment.

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大类 | 2 区 医学
小类 | 2 区 卫生保健与服务
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Q3 HEALTH CARE SCIENCES & SERVICES
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第一作者机构: [1]Shanghai Jiao Tong Univ, Ruijin Hosp, Clin Res Ctr, Sch Med, Shanghai, Peoples R China
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通讯机构: [3]Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Lab Med, Shanghai, Peoples R China [4]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Clin Microbiol, Sch Med, Shanghai, Peoples R China [6]Shanghai Jiao Tong Univ, Ruijin Hosp, Emergency Dept, Sch Med, Shanghai, Peoples R China [7]Wuhan Univ, Wuhan Hosp 3, Dept Gastroenterol, Tongren Hosp, Wuhan, Peoples R China [*1]Department, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [*2]Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [*3]Department of Gastroenterology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
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