Development and validation of a predictive scoring system for in-hospital mortality in COVID-19 Egyptian patients: a retrospective study

Elgohary, Mohamed Abdel‐Salam; Ali, Asmaa; El‐Masry, Thanaa A.; Faidah, Hani; Bantun, Farkad; Elkholy, Ahmad M; Fahim, Jaklin S; Elgamal, Nabila N; Mohamed, Mohamed Emam; Seadawy, Mohamed G.; Helal, Amro M; Waard, Michel De; Shishtawy, Hesham M; El‐Bouseary, Maisra M.

doi:10.1038/s41598-022-26471-w

Sci Rep

2022

DOI: 10.1038/s41598-022-26471-w

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Development and validation of a predictive scoring system for in-hospital mortality in COVID-19 Egyptian patients: a retrospective study

Mohamed Abdel‐Salam Elgohary

Asmaa Ali

Thanaa A. El‐Masry

et al.

Abstract: SARS-CoV-2 virus has rapidly spread worldwide since December 2019, causing COVID-19 disease. In-hospital mortality is a common indicator for evaluating treatment outcomes. Therefore, the developing and validating a simple score system from observational data could assist in modulating the management procedures. A retrospective cohort study included all data records of patients with positive PCR for SARS-CoV-2. The factors that associated with mortality were analyzed, then allocation of potential predictors of … Show more

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2023

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Cited by 2 publications

References 67 publications

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Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19

Ali

Abdelhafiz

et al. 2023

BMC Pulm Med

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Background Severe COVID-19 disease is typically associated with an urgent need for supplemental oxygen therapy that may be successfully delivered through conventional methods or require invasive mechanical ventilation. Early prediction of the need for invasive mechanical ventilation could significantly improve outcomes of COVID-19 patients. Plasma levels of D-dimer and a number of inflammatory markers as well as values of complete blood counts, all measured in the first two days of hospital admission of COVID-19 patients, were evaluated for their significance as predictors of the eventual need for invasive mechanical ventilation support as well as their values as predictors of post-ventilation morbidly and mortality. Methods This retrospective cohort study was conducted at a single center and included data pertaining to 200 patients with previously confirmed moderate to severe COVID-19 disease in the period between May 2021 and the end of December 2022. Data were retrieved from medical records for further analysis. Results The mean (SD) age of patients stood at 59 (14) years of age, and with a majority of patients being male (77%). About 18% of cases, all of significantly older age, had been connected to invasive mechanical ventilation (IMV). Total leucocytic count (TLC), as well as levels of urea, creatinine, D-dimer, ferritin, and CRP in IMV patients were significantly higher than non-ventilated patients (p < 0.01 for all). In contrast, lymphocytic count, hemoglobin level, and platelet count were significantly lower in IMV patients (p < 0.001, 0.04, and 0.002, respectively). The mortality rate was significantly higher in IMV patients (p < 0.001). D-dimer independently predicted IMV demand (OR = 1, p = 0.001 in adjusted and unadjusted models). The utility of D-dimer was excellent; and the cutoff level of above 1415 µ/L showed sensitivity and specificity of about 92% and 76%, respectively. Also, the D-dimer level was very effective in predicting post-IMV survival; the AUC = 0.86, p = 0.02, and a cutoff value below 4558 µ/L was associated with 100% and 66% sensitivity and specificity, respectively. Conclusions High D-dimer levels independently correlated with the need for invasive mechanical ventilation. Low levels of this marker could evidently predict post-IMV survival of mechanically ventilated COVID-19 patients. Measuring D-dimer levels during routine follow up of those patients would thus be useful in predicting patient outcomes.

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Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19

Ali

Abdelhafiz

et al. 2023

BMC Pulm Med

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Point Prevalence Survey of Antimicrobial Use and Resistance during the COVID-19 Era among Hospitals in Saudi Arabia and the Implications

Haseeb,

Abuhussain,

Alghamdi

et al. 2023

Antibiotics

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The inappropriate prescribing of antimicrobials increases antimicrobial resistance (AMR), which poses an appreciable threat to public health, increasing morbidity and mortality. Inappropriate antimicrobial prescribing includes their prescribing in patients hospitalized with COVID-19, despite limited evidence of bacterial infections or coinfections. Knowledge of current antimicrobial utilization in Saudi Arabia is currently limited. Consequently, the objective of this study was to document current antimicrobial prescribing patterns among Saudi hospitals during the COVID-19 pandemic. This study included patients with or without COVID-19 who were admitted to five hospitals in Makkah, Saudi Arabia. Data were gathered using the Global PPS methodology and analyzed using descriptive statistics. Out of 897 hospitalized patients, 518 were treated with antibiotics (57.7%), with an average of 1.9 antibiotics per patient. There were 174 culture reports collected, representing 36.5% of all cases. The most common indication for antibiotics use was community-acquired infections, accounting for 61.4% of all cases. ‘Watch’ antibiotics were the most commonly prescribed antibiotics, with the cephalosporins and carbapenems representing 38.7% of all antibiotics prescribed, followed by the penicillins (23.2%). Notably, Piperacillin/Tazobactam and Azithromycin were prescribed at relatively higher rates for COVID-19 patients. These findings highlight the need for continuous efforts to optimize the rational use of antibiotics through instigating appropriate antimicrobial stewardship programs in hospitals and, as a result, reduce AMR in the country.

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Development and validation of a predictive scoring system for in-hospital mortality in COVID-19 Egyptian patients: a retrospective study

Cited by 2 publications

References 67 publications

Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19

Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19

Point Prevalence Survey of Antimicrobial Use and Resistance during the COVID-19 Era among Hospitals in Saudi Arabia and the Implications

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