The mortality predictors in non-vaccinated COVID-19 patients

Aim: The novel coronavirus (SARS-CoV-2) causes COVID-19 disease. From December 31, 2019, to the present (July 2022), 545 million new cases have been detected, while the number of deaths due to the disease has reached 6.3 million. This study aims to reveal mortality-related risk factors, including comorbid conditions, clinical course, imaging, and laboratory parameters in COVID-19 patients hospitalized in a tertiary hospital. Material and Method: An observational, retrospective study was conducted among hospitalized COVID-19 patients at the tertiary health center in Turkey between November 2020 and April 2021. A total of 601 patients were treated in this period and vaccinated 85 patients were excluded. The remaining 516 patients’ demographical data, clinical severity, laboratory parameters, thorax computed tomography (CT) involvement, and mortalities were recorded. Results: In evaluating the factors affecting COVID-19 mortality, it was observed that male gender and advanced age were significantly associated with mortality, and the mortality rate was higher in patients with involvement in thorax CT and patients with a clinically severe course. In the evaluation of the patients in terms of comorbidities, DM, HT, and CAD were significantly higher in the patients who died. It was determined that patients who died during hospitalization needed respiratory support at a higher rate. Conclusion: Identifying predicting factors is essential for the early recognition the vulnerable patients for hospitalization decisions and early aggressive treatment. In this study, male gender, advanced age, comorbidities (DM, HT, CAD), pulmonary involvement, and severe clinical presentation were identified as significantly related factors associated with mortality.

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  • WHO Coronavirus (COVID-19) Dashboard 2022 (Available from: https://covid19.who.int/ ).
  • Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 2020; 395:1763-70.
  • Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020; 584: 430-6.
  • Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020; 55: 2000547.
  • Zadori N, Vancsa S, Farkas N, Hegyi P, Eross B, Group KS. The negative impact of comorbidities on the disease course of COVID-19. Intensive Care Med 2020; 46: 1784-6.
  • Kokturk N, Babayigit C, Kul S, et al. The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients. Respir Med 2021; 183: 106433.
  • Romero-Gameros CA, Vargas-Ortega G, Rendon-Macias ME, et al. Risk factors associated with mortality among patients with COVID-19: analysis of a cohort of 1213 patients in a tertiary healthcare center. J Clin Med 2022; 11: 2780.
  • WorldHealthOrganization. Clinical management: living guidance. Jan 25, 2021 2021.
  • Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62.
  • Jin JM, Bai P, He W, et al. gender differences in patients with COVID-19: focus on severity and mortality. Front Public Health 2020; 8: 152.
  • Yuan M, Yin W, Tao Z, Tan W, Hu Y. Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. PLoS One 2020; 15: e0230548.
  • Zakariaee SS, Salmanipour H, Naderi N, Kazemi-Arpanahi H, Shanbehzadeh M. Association of chest CT severity score with mortality of COVID-19 patients: a systematic review and meta-analysis. Clin Transl Imaging 2022: 1-14.
  • Parra-Bracamonte GM, Lopez-Villalobos N, Parra-Bracamonte FE. Clinical characteristics and risk factors for mortality of patients with COVID-19 in a large data set from Mexico. Ann Epidemiol 2020; 52: 93-8.
  • Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost 2020;18: 1324-9.
  • Wang L, He W, Yu X, et al. Coronavirus disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect 2020; 80: 639-45.
  • Tan L, Wang Q, Zhang D, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther 2020; 5: 33.
  • Güngörer B. Baseline demographic, clinical and laboratory risk factors for predicting admission to intensive care unit in patients diagnosed with COVID-19 in the emergency department. Anatolian Current Med J 2021; 3: 279-83.