Risk factors of the severe course and fatal outcome in COVID-19

Abstract

Since its first detection, coronavirus disease 2019 (COVID-19) caused by coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has spread rapidly around the world. Although coronavirus SARS-CoV-2 primarily targets the respiratory system, complications in other organ systems (cardiovascular, neurological, and renal) can also contribute to death from the disease. Clinical experience thus far has shown substantial heterogeneity in the trajectory of SARS-CoV-2 infection, spanning from asymptomatic to mild, moderate, and severe disease forms with low survival rates. Accurate prediction of COVID-19 mortality and the identification of contributing factors would allow for targeted strategies in patients with the high risk of death. We aimed to identify clinical and laboratory features that contributed the most to this prediction. An improved understanding of predictive factors for COVID-19 is crucial for identify those with higher risk of mortality and for clinical decision making to reduce the risk of death. The main risk factors for the severe course of COVID-19, the development of complications and death include old age, concomitant diseases (cardiovascular diseases, chronic lung diseases, diabetes mellitus and hypertension), body temperature 37.8C, oxygen saturation 92%, quantitative and functional depletion of innate immunity, bilateral pulmonary infiltrates, increased levels of laboratory parameters of systemic inflammation, respiratory, cardiac, renal and/or hepatic failure. Proper assessment of prognostic factors and careful monitoring to ensure the necessary interventions at the appropriate time in high-risk patients can reduce the fatality rate from COVID-19.

Characteristics of hospitalized patients with lethal outcome due to COVID-19

“…Факторами риска летального исхода являлись пожилой возраст (объединенное отношение шансов (pOR) и объединенное отношение рисков (pHR): 2,61 (95% ДИ: 1,75 -3,47) и 1,31 (95% ДИ: 1,11 -1,51) соответственно), мужской пол (pOR = 1,45; 95% ДИ: 1,41 -1,51; pHR = 1,24; 95% ДИ: 1,07 -1,41), курение (pOR = 1,42; 95% ДИ: 1,01 -1,83) [6]. По мнению экспертов ВОЗ, наиболее значимым фактором риска летального исхода при COVID-19 являлись сопутствующая патология, включая сахарный диабет (СД), сердечно-сосудистые заболевания (ССЗ), хроническую обструктивную болезнь лёгких (ХОБЛ) и острую почечную недостаточность [7].…”