Predictors of mortality in patients less than 50 years old with coronavirus disease 2019: a multicenter experience in Istanbul

Abstract

OBJECTIVE:The objectives of this study were to identify predictors of mortality in young adult patients with coronavirus disease 2019 and to assess the link between blood type and mortality in those patients. METHODS: This multicenter retrospective study, which was conducted in seven training and research hospitals in Istanbul, involved young adults who aged ≥18 and <50 years and hospitalized with coronavirus disease 2019. RESULTS: Among 1,120 patients, confusion at admission (p<0.001) and oxygen saturation (p<0.001) were significantly predictive factors of mortality. Blood type O was significantly associated with mortality compared to those discharged from the hospital (p<0.001). Among co-morbidities, the most reliable predictive factors were cerebral vascular disease (p<0.001) and chronic renal failure (p=0.010). Among laboratory parameters, high C-reactive protein (p<0.001) and low albumin (p<0.001) levels were predictors of mortality in young adult patients with coronavirus disease 2019. CONCLUSIONS: SpO 2 at admission was the best predictor of mortality in young adult patients with coronavirus disease 2019. The mortality rate was increased by cerebral vascular disease and chronic renal failure. Also, high C-reactive protein and low albumin levels were predictive factors of mortality. Moreover, blood type O was associated with a higher mortality rate than the other types.

Importance of Demographic and Clinical Features in Evaluating the Severity of COVID-19 in Hospitalized Patients: A Serbian Retrospective Study in the First Pandemic Year

“…Laboratory markers associated with increased risk for severe disease include lymphocytopenia, neutrophilia, and elevated serum ALT, AST, LDH, CRP, and ferritin [23,24]. Furthermore, our results agree with the majority of authors [5,7,21,25] in that lymphopenia and elevated values of AST and LDH were statistically significantly more frequent in patients with severe forms of the disease. We can assume that a reduced number of lymphocytes is a consequence of viral attachment, damage to the immune system, or exudation of circulating lymphocytes into the inflammatory lung tissue.…”

“…Moreover, in our patients, there is a statistically significant difference in ALP values between the groups, which was significantly lower in patients with severe disease. While the results of Turkish researchers show that, except for saturation, both high CRP and low albumin are good predictors of mortality [21], our results also show that high CRP, as well as low albumin and hypoproteinemia on admission, show significant differences between patients who had mild/moderate and severe disease. Our results are in agreement with other authors whose research shows that high CRP and low albumin values are important for the development of a severe form of the disease [26,27], indicating the development of cytokine storms in patients with COVID-19.…”

“…Oxygen saturation on admission was the best predictor of mortality in examined patients aged 18 to 50 years [21]. Furthermore, our results showed that patients with significantly lower oxygen saturation and the consequent need for oxygen support already on admission had a severe disease.…”

The laboratory parameters in predicting the severity and death of COVID-19 patients: Future pandemic readiness strategies

“…The study reported the highest odds ratio for individuals with albumin levels falling below 3.5 g/dL (OR ═ 14.318; P < 0.001) ( Table 1 ) [ 6 ]. Furthermore, oxygen saturation upon hospital admission stood out as the most potent predictor of mortality among COVID-19 patients aged 18–50, according to another recent study [ 66 ].…”

“…The most common laboratory abnormalities seen in hospitalized COVID-19 patients include lymphocytopenia accompanied by an elevated neutrophil count, thrombocytopenia, anemia, raised LDH levels, D-dimer, CRP, liver enzymes, and decreased albumin levels [ 67–69 ]. Specific markers, such as lymphocytopenia, neutropenia, elevated serum liver enzymes, LDH, CRP, and ferritin, have been associated with an elevated risk of severe disease [ 66 , 70 , 71 ]. Elevated levels of CRP and reduced albumin levels are crucial indicators of severe disease progression [ 72 , 73 ], indicating the development of cytokine storm in COVID-19 patients.…”