International Journal of General Medicine (Mar 2022)

Analysis of Deaths and Favorable Developments of Patients with SARS-CoV-2 Hospitalized in the Largest Hospital for Infectious Diseases and Pneumo-Phthisiology in the West of the Country

  • Laza R,
  • Dragomir C,
  • Musta VF,
  • Lazureanu VE,
  • Nicolescu ND,
  • Marinescu AR,
  • Paczeyka R,
  • Porosnicu TM,
  • Bica-Porfir V,
  • Laitin SMD,
  • Dragomir I,
  • Ilie C,
  • Baditoiu LM

Journal volume & issue
Vol. Volume 15
pp. 3417 – 3431

Abstract

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Ruxandra Laza,1,2 Cristina Dragomir,3 Virgil Filaret Musta,1,2 Voichita Elena Lazureanu,1,2 Narcisa Daniela Nicolescu,1,2 Adelina Raluca Marinescu,1– 3 Roxana Paczeyka,2 Tamara Mirela Porosnicu,2,3 Valerica Bica-Porfir,2 Sorina Maria Denisa Laitin,2,4 Ion Dragomir,5 Constantin Ilie6 ,† Luminita Mirela Baditoiu4,7 1Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania; 2Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes”, Timisoara, 300310, Romania; 3Doctoral School, University of Medicine and Pharmacy “Victor Babes”, Timisoara, 300041, Romania; 4Department XIII, Discipline of Epidemiology, University of Medicine and Pharmacy “Victor Babes”, Timisoara, 300041, Romania; 5Individual Family Medical Office, Ostroveni, Dolj, Romania; 6Department XII, Discipline of Neonatology and Childcare, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania; 7Multidisciplinary Research Centre on Antimicrobial Resistance, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania†Constantin Ilie passed away on 27 January 2022Correspondence: Luminita Mirela Baditoiu, Cristina Dragomir Department XIII, Discipline of Epidemiology, Victor Babes University of Medicine and Pharmacy; Doctoral School, University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, Timisoara, 300041, Romania, Tel +40727746440 ; +40753036306, Email [email protected]; [email protected]: Romania is one of the European countries that has been hit the hardest by the severe acute respiratory syndrome caused by the new coronavirus SARS-CoV-2, with over 1.91 million reported cases and over 59,257 deaths. The aim of this study was to identify the main predictors of death in hospitalized patients.Patients and Methods: In the period from 1 March 2020 to 30 June 2021, an observational, retrospective, randomized, case-control study was conducted, which included a sample of 139 patients who died in hospital and another sample of 275 patients who had been discharged in an improved or healed condition. Confirmation of COVID-19 cases was performed by RT-PCR from nasopharyngeal and oropharyngeal exudates. Statistical data were analyzed by logistic regression, Cox regression and a comparison of survival curves by the log-rank (Mantel-Cox) test.Results: The most powerful logistic regression model identified the following independent predictors of death: history of coagulopathy HR = 30.73 [1.94– 487.09], p = 0.015; high percentage of neutrophils HR = 1.09 [1.01– 1.19], p = 0.027; and decreased blood-oxygenation HR = 53881.97 [1762.24– 1647489.44], p < 0.001. Cox regression identified the following factors that influenced the evolution of cases: history of coagulopathy HR = 2.44 [1.38– 4.35], p = 0.000; O2 saturation HR = 0.98 [0.96– 0.99], p = 0.043; serum creatinine HR = 1.23 [1.08– 1.39], p = 0.001; dyspnea on admission HR = 2.99 [1.42– 6.30], p = 0.004; hospitalization directly in the ICU HR = 3.803 [1.97– 7.33], p < 0.001; heart damage HR = 16.76 [1.49– 188.56], p = 0.022; and decreased blood-oxygenation HR = 35.12 [5.92– 208.19], p < 0.001.Conclusion: Knowledge of the predictors of death in hospitalized patients allows for the future optimization of triage and therapeutic case management for COVID-19.Keywords: complications, comorbidities, COVID-19, protection factors, risk factors, survival

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