Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia
Early identification of patients with COVID-19 who will develop severe or critical disease symptoms is important for delivering proper and early treatment. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings that may be of utility to clinicians in p...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Metabolites |
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| Online Access: | https://www.mdpi.com/2218-1989/11/10/679 |
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| author | Maamoun Basheer Elias Saad Rechnitzer Hagai Nimer Assy |
| author_facet | Maamoun Basheer Elias Saad Rechnitzer Hagai Nimer Assy |
| author_sort | Maamoun Basheer |
| collection | DOAJ |
| description | Early identification of patients with COVID-19 who will develop severe or critical disease symptoms is important for delivering proper and early treatment. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings that may be of utility to clinicians in predicting COVID-19 severity and mortality. Electronic medical record data from patients diagnosed with COVID-19 from November 2020 to June 2021 in the COVID-19 Department in the Galilee Medical Center, Nahariya, Israel, were collected. Epidemiologic, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression analyses and discriminant analyses were used to identify and validate powerful predictors. The main outcome measure was invasive ventilation, or death. The study population included 390 patients, with a mean age of 61 ± 18, and 51% were male. The non-survivors were mostly male, elderly and overweight and significantly suffered from hypertension, diabetes mellitus type 2, lung disease, hemodialysis and past use of aspirin. Four predictive factors were found that associated with increased disease severity and/or mortality: age, NLR, BUN, and use of high flow oxygen therapy (HFNC). The AUC or diagnostic accuracy was 87%, with a sensitivity of 97%, specificity of 60%, PPV of 87% and NPP of 91%. The cytokine levels of CXCL-10, GCSF, IL-2 and IL-6 were significantly reduced upon the discharge of severely ill COVID-19 patients. The predictive factors associated with increased mortality include age, NLR, BUN, and use of HFNC upon admission. Identifying those with higher risks of mortality could help in early interventions to reduce the risk of death. |
| first_indexed | 2024-03-10T06:23:41Z |
| format | Article |
| id | doaj.art-18dbef9151a74f62a12c895f179f8100 |
| institution | Directory Open Access Journal |
| issn | 2218-1989 |
| language | English |
| last_indexed | 2024-03-10T06:23:41Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Metabolites |
| spelling | doaj.art-18dbef9151a74f62a12c895f179f81002023-11-22T19:07:17ZengMDPI AGMetabolites2218-19892021-10-01111067910.3390/metabo11100679Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 PneumoniaMaamoun Basheer0Elias Saad1Rechnitzer Hagai2Nimer Assy3Internal Medicine Department, Galilee Medical Center, Nahariya 2210001, IsraelInternal Medicine Department, Galilee Medical Center, Nahariya 2210001, IsraelThe Microbiology Lab, Galilee Medical Center, Nahariya 2210001, IsraelInternal Medicine Department, Galilee Medical Center, Nahariya 2210001, IsraelEarly identification of patients with COVID-19 who will develop severe or critical disease symptoms is important for delivering proper and early treatment. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings that may be of utility to clinicians in predicting COVID-19 severity and mortality. Electronic medical record data from patients diagnosed with COVID-19 from November 2020 to June 2021 in the COVID-19 Department in the Galilee Medical Center, Nahariya, Israel, were collected. Epidemiologic, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression analyses and discriminant analyses were used to identify and validate powerful predictors. The main outcome measure was invasive ventilation, or death. The study population included 390 patients, with a mean age of 61 ± 18, and 51% were male. The non-survivors were mostly male, elderly and overweight and significantly suffered from hypertension, diabetes mellitus type 2, lung disease, hemodialysis and past use of aspirin. Four predictive factors were found that associated with increased disease severity and/or mortality: age, NLR, BUN, and use of high flow oxygen therapy (HFNC). The AUC or diagnostic accuracy was 87%, with a sensitivity of 97%, specificity of 60%, PPV of 87% and NPP of 91%. The cytokine levels of CXCL-10, GCSF, IL-2 and IL-6 were significantly reduced upon the discharge of severely ill COVID-19 patients. The predictive factors associated with increased mortality include age, NLR, BUN, and use of HFNC upon admission. Identifying those with higher risks of mortality could help in early interventions to reduce the risk of death.https://www.mdpi.com/2218-1989/11/10/679SARS-COV-2NLRhigh flowBUNinsulin resistancemortality |
| spellingShingle | Maamoun Basheer Elias Saad Rechnitzer Hagai Nimer Assy Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia Metabolites SARS-COV-2 NLR high flow BUN insulin resistance mortality |
| title | Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia |
| title_full | Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia |
| title_fullStr | Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia |
| title_full_unstemmed | Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia |
| title_short | Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia |
| title_sort | clinical predictors of mortality and critical illness in patients with covid 19 pneumonia |
| topic | SARS-COV-2 NLR high flow BUN insulin resistance mortality |
| url | https://www.mdpi.com/2218-1989/11/10/679 |
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