Predictors of mortality, ICU hospitalization, and extrapulmonary complications in COVID-19 patients

Abstract

Objective. A major coronavirus disease 2019 (COVID-19) outbreak occurred in Northeastern France in spring 2020. This single-center retrospective observational cohort study aimed to compare patients with severe COVID-19 and those with non-severe COVID-19 (survivors vs. non-survivors, ICU patients vs. non-ICU patients) and to describe extrapulmonary complications. Patients and methods. We included all patients with a confirmed diagnosis of COVID-19 admitted to Colmar Hospital in March 2020. Results. We examined 600 patients (median age 71.09 years; median body mass index: 26.9 kg/m 2 ); 57.7% were males, 86.3% had at least one comorbidity, 153 (25.5%) required ICU hospitalization, and 115 (19.1%) died. Baseline independent factors associated with death were older age (>75 vs. ≤75 years), male sex, oxygen supply, chronic neurological, renal, and pulmonary diseases, diabetes, cancer, low platelet and hemoglobin counts, and high levels of C-reactive protein (CRP) and serum creatinine. Factors associated with ICU hospitalization were age <75 years, oxygen supply, chronic pulmonary disease, absence of dementia, and high levels of CRP, hemoglobin, and serum creatinine. Among the 600 patients, 80 (13.3%) had an acute renal injury, 33 (5.5%) had a cardiovascular event, 27 (4.5%) had an acute liver injury, 24 (4%) had venous thromboembolism, eight (1.3%) had a neurological event, five (0.8%) had rhabdomyolysis, and one had acute pancreatitis. Most extrapulmonary complications occurred in ICU patients. Conclusion. This study highlighted the main risk factors for ICU hospitalization and death caused by severe COVID-19 and the frequency of numerous extrapulmonary complications in France.

Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

“…Overall, most adults infected by COVID-19 self-resolve, while approximately 20% progress and many require hospitalization. The elderly and those with comorbidities (immunocompromise, cardiopulmonary disease, cancer, diabetes, obesity, and kidney failure) are at heightened risk of experiencing rapid disease progression and mortality [ 3 ]. These comorbidities have in common chronic systemic inflammation, a higher prevalence of sarcopenia, loss of lean body mass, and protein-calorie malnutrition, which impairs immunity to infectious agents, such as SARS-CoV-2 [ 4 , 5 , 6 , 7 , 8 ].…”

Acute kidney injury in patients with COVID-19 in the intensive care unit: evaluation of risk factors and mortality in a national cohort

“…Several studies report acute kidney injury (AKI) among hospitalised patients with COVID-19 while less data are obtained exclusively in intensive care unit (ICU) patients. [2][3][4][5][6][7][8][9][10] To our knowledge, previous studies are not based on all ICU admissions within a large population. Furthermore, there is a call from the consensus report on COVID-19 associated AKI published by the 25th Acute Dialysis Quality Initiative (ADQI) Workgroup that studies should 'incorporate the information about the proportion of different comorbidities in patients with and without AKI, including potential risk factors for the development of AKI'.…”

Multifactor Logistic Analysis to Explore the Risk Factors of Safety Risks in the Transport of Critically Ill Patients with ICU and the Improvement of Nursing Strategies

“…The side effects of the patients during the transfer may be related to the patient's condition, the excellent transfer equipment, the ability of the transfer personnel or the communication between the teams, the preparation before the transfer, and the monitoring during the transfer [ 8 ]. According to reports of adverse events during in-hospital transport, patients had different types of complications during in-hospital transport, of which 42.4% of the complications were related to hypoxia [ 9 ].…”