COVID-19 Independent Risk Factors for Unfavorable Disease Progression: A Cross-Sectional Study from Romania

Abstract

Ruxandra Laza,1,2 Voichita Elena Lazureanu,1,2 Virgil Filaret Musta,1,2 Narcisa Daniela Nicolescu,1,2 Corina Vernic,3 Anca Tudor,3 Roxana Critu,4 Laura Vilceanu,2 Roxana Paczeyka,2 Valerica Bica Profir,2 Adelina Raluca Marinescu,1,2,4 Alexandra Mocanu,2,4 Talida Georgiana Cut,1,2,4,5 Daniel Florin Lighezan,6,7 Luminita Mirela Baditoiu8,9 1Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 2Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, Romania; 3Department III, Discipline of Medical Informatics and Biostatistics, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 4Doctoral School, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 5Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 6Department of Internal Medicine I, Discipline of Medical Semiology I, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 7Municipal Emergency Hospital, Timisoara, Romania; 8Department XIII, Discipline of Epidemiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 9Multidisciplinary Research Center of Antimicrobial Resistance, Victor Babes University of Medicine and Pharmacy, Timisoara, RomaniaCorrespondence: Talida Georgiana Cut, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, Timisoara, 300041, Romania, Tel [phone], Email [email protected]: Since the initial documentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late December 2019, the coronavirus disease 2019 (COVID-19) pandemic has become a leading cause of morbidity and mortality worldwide. Under these circumstances, the present study aimed to analyze the characteristics of hospitalized cases, according to the progression and severity of the disease, to reveal the main independent risk factors for death by COVID-19 in the western Romanian population.Patients and Methods: This retrospective study included 936 patients admitted to Victor Babes Clinical Hospital of Infectious Diseases Timisoara, with COVID-19 between 1 February 2020 and 31 January 2021. The patients were divided into three subsamples based on disease severity: subsample I (n = 344), comprising patients with mild forms of the disease; subsample II (n = 475) comprising patients with moderate disease; and subsample III (n = 117) for patients with severe disease. Biochemical analysis and assessment of disease severity were performed on all patients.Results: The mean age was 48.76 years (two months to 94 years). The median values for age, number of hospitalization days, and disease duration days before hospital admission varied with high statistical significance between the three subsamples (p < 0.001). A statistically significant difference was also observed regarding body mass index (BMI), with higher values in subsample III (p < 0.001). The in-hospital fatality rate was zero in subsample I, 3.58% in subsample II, and 71.79% in subsample III (p < 0.001). Of the deceased patients, 69.31% were over the age of 65 years, 29.70% were aged 36– 64 years, and 0.99% were aged 19– 35 years. Cumulated comorbidities were recorded in 92.08% of the deceased patients.Conclusion: Older age, the number of disease duration days before hospital admission, BMI, and renal pathology are independent risk factors for mortality in COVID-19 and can help clinicians to identify patients with poor prognosis and who are at high risk for mortality at an early stage.Keywords: severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, fatality rate, disease severity, risk factors

Keywords

• severe acute respiratory syndrome coronavirus 2 (sars-cov-2)
• fatality rate
• disease severity
• risk factors