Predictors of mortality of hospitalized COVID-19 pneumonia patients in university hospital

Abstract

Introduction COVID-19 pneumonia is a leading cause for worse outcome of infected patients. Factors associated with mortality in COVID-19 pneumonia vary among studies; identification of most possible factors related to worse outcome might add for management. Patients and methods Consecutive COVID-19 pneumonia patients referred to the Assiut University Hospital, Egypt, from June 2020 to August 2022 were included in our study. All the included patients were followed up from admission until discharge to identify the factors that worsen the outcome. Our cohort study includes two groups: survivors and non-survivors. Clinical, laboratory, and management data of both groups were recorded. Results Two-hundred and fifty-one confirmed COVID-19 pneumonia patients were included in the study; 147 (58.6%) patients were improved (survivors’ group), and 104 (41.4%) patients were deteriorated and died (non-survivors’ group). Non-survivors’ group had significantly higher MMRC dyspnea scale, pneumonia severity index, CURB-65 score, and baseline respiratory rate. Non-survivors group had significantly lower mean lymphocytes (0.81 ± 0.61 vs. 1.25 ± 0.75; p < 0.001), higher ferritin (1272.45 ± 143.76 vs. 615.84 ± 75.47; p < 0.001), and higher d-dimer (6.65 ± 2.67 vs. 2.78 ± 0.38; p < 0.001), with interestingly significantly higher mean platelet volume (MPV) (10.34 ± 1.64 vs. 10.07 ± 1.93 (fl); p < 0.001). Non-survivors group was frequently admitted to ICU (88 (84.6%) vs. 38 (25.9%); p < 0.001) and had longer duration in ICU than survivors group (9.71 ± 3.36 vs. 5.90 ± 2.34 (days); p < 0.001). The predictors for mortality among patients with COVID-19 pneumonia were old age, high MPV, high CT score, and admission to ICU. Conclusion Old age, severe lung infiltrate with HRCT, high mean platelet volume, and ICU admission are the main clinical determinants of worse outcome of COVID-19 pneumonia.