A Predictive Model and Risk Factors for Case Fatality of COVID-19

Abstract

This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience of medical resources. This is an observational, analytical, retrospective cohort study with longitudinal follow-up. Data were collected from the medical records of 3489 patients diagnosed with COVID-19 using RT-qPCR in the period of highest community transmission recorded in Europe to date: February–June 2020. The study was carried out in in two health areas of hospital care in the Madrid region: the central area of the Madrid capital (Hospitales de Madrid del Grupo HM Hospitales (CH-HM), n = 1931) and the metropolitan area of Madrid (Hospital Universitario Príncipe de Asturias (MH-HUPA) n = 1558). By using a regression model, we observed how the different patient variables had unequal importance. Among all the analyzed variables, basal oxygen saturation was found to have the highest relative importance with a value of 20.3%, followed by age (17.7%), lymphocyte/leukocyte ratio (14.4%), CRP value (12.5%), comorbidities (12.5%), and leukocyte count (8.9%). Three levels of risk of ICU/death were established: low-risk level (<5%), medium-risk level (5–20%), and high-risk level (>20%). At the high-risk level, 13% needed ICU admission, 29% died, and 37% had an ICU–death outcome. This predictive model allowed us to individualize the risk for worse outcome for hospitalized patients affected by COVID-19.

Effect of Vitamin D Supplementation on Muscle Status in Old Patients Recovering from COVID-19 Infection

“…They have been reported to be useful for monitoring and predicting disease outcome and prognosis [20,21]. A recently published study [22] created a model for individualized analysis of the risk of admission or death of patients with COVID-19 in an intensive care unit (ICU). This could be a useful tool for rapid clinical management and for achieving resilience of medical resources.…”

A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities

“…This silent hypoxemia is not characterized by typical respiratory distress in critically ill patients, but it may be dangerous if it is not sooner detected as a prompt deterioration can occur without noticing [137]. In fact, previous studies have demonstrated the association between hypoxemia with fatal outcomes in patients with COVID-19 [138].…”

“…This silent hypoxemia is not characterized by typical respiratory distress in critically ill patients, but it may be dangerous if it is not sooner detected as a prompt deterioration can occur without noticing [ 137 ]. In fact, previous studies have demonstrated the association between hypoxemia with fatal outcomes in patients with COVID-19 [ 138 ]. In the same manner, physicians observed that patients exhibit hypoxemia without dyspnea, being crucial to find care solutions to anticipate a problem with more patients at important risk [ 139 ].…”

An Updated Review of SARS-CoV-2 Vaccines and the Importance of Effective Vaccination Programs in Pandemic Times

“…However, if the immune response fails, SARS-CoV-2 may be able to disseminate throughout the organism, promoting an aberrant immune response with uncontrolled cytokine production (a so-called “cytokine storm”), acute respiratory-distress syndrome (ARDS), and multiorgan failure [ 33 ]. In fact, immune cells, as well as inflammatory components, have been proven to be valuable markers for predicting COVID-19 fatality [ 34 ]. Therefore, it is crucial to ensure an adequate immune response to prevent or mitigate SARS-CoV-2 infection.…”