Predictors of Mortality in Hospitalized COVID-19 Patients Complicated With Hypotension and Hypoxemia: A Retrospective Cohort Study

Abstract

Introduction: COVID-19 patients with hypotension and hypoxemia had a significantly worse outcome. The purpose of this research was to ascertain the risk factors affecting the prognoses of these patients and to develop appropriate prognostic prediction tools.Methods: From March 1, 2020, to April 16, 2020, a retrospective cohort analysis of COVID-19 patients with hypotension and hypoxemia was performed. The univariate and multivariate analyses were performed to identify the associated risk factors influencing the prognosis of COVID-19 patients with hypotension and hypoxemia, and the selected variables were then utilized to construct and validate the prediction model for these patients.Results: Three hundred and twenty-seven COVID-19 patients with hypotension and hypoxemia who met the inclusion and exclusion criteria were included in this study. Age, temperature, troponin, and blood glucose were related to mortality in COVID-19 patients with hypotension and hypoxemia in both univariate and multivariate analyses. The MFP model (multiple fractional polynomial model), full model, and stepwise model were utilized to build the prediction model, and their AUCs were, respectively, 0.902 (0.868, 0.936), 0.902 (0.868, 0.936), and 0.902 (0.868, 0.936). Because the sample size for this research was limited, we utilized bootstrapping for internal validation. The AUCs of Bootstrap full and Bootstrap stepwise were 0.902 (0.867, 0.936) and 0.902 (0.868, 0.936), respectively.Conclusion: Age, temperature, troponin, and blood glucose levels were associated with mortality in COVID-19 patients with hypotension and hypoxemia. Additionally, the prediction model developed using the variables above showed a high predictive value for predicting the prognosis of these individuals.

Zymosan Particle-Induced Hemodynamic, Cytokine and Blood Cell Changes in Pigs: An Innate Immune Stimulation Model with Relevance to Cytokine Storm Syndrome and Severe COVID-19

“…CSS is, however, not the only sign of bad prognosis in late-stage COVID-19. Another one is the association of neutrophilia with lymphopenia, manifested in a rise in neutrophil/lymphocyte ratio (NLR) [ 24 , 25 ], and yet another is hemodynamic instability, including pulmonary hypertension [ 26 , 27 , 28 ] and/or systemic hypotension [ 29 , 30 ]. These symptoms can also arise in COVID-19 independent CSS [ 24 , 25 , 26 , 27 , 28 ]; thus, they are manifestations of the immune derangement, rather than direct consequences of the infection with SARS-CoV-2 virus.…”

Predictors of Mortality in Hospitalized Covid-19 Patients

“…As of May 2022, there are more than six million COVID-19 related deaths worldwide (https://covid19.who.int). Mild presentation occurs in approximately 80% of persons with COVID-19, whereas moderate to severe disease is seen in about 14% of cases, and critical illness was reported in 5% of those infected [2]. Patients with severe manifestations may require admission to an intensive care unit (ICU) [3].…”

Zymosan-induced leukocyte and cytokine changes in pigs: a new model for streamlined drug testing against severe COVID-19

“…Another one is the association of neutrophilia with lymphopenia, manifested in a rise of neutrophil/lymphocyte ratio (NLR), 24,25 and yet another is hemodynamic derangement, such as pulmonary hypertension [26][27][28] and/or systemic hypotension. 29,30 Peculiarly, hemodynamic derangement and WBC differential changes are also characteristic features of the pigs' response to i.v. administered nanoparticles.…”

“…Another one is the association of neutrophilia with lymphopenia, manifested in a rise of neutrophil/lymphocyte ratio (NLR), 24,25 and yet another is hemodynamic derangement, such as pulmonary hypertension 26-28 and/or systemic hypotension. 29,30…”