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Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department
Introduction: A cluster of atypical pneumonia cases in Wuhan, China, turned out to be a highly contagious disease, swept across most of the countries, and soon after was announced as a pandemic. Therefore we aimed to investigate the demographics and factors associated with the disease outcome. Metho...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863081/ https://www.ncbi.nlm.nih.gov/pubmed/33564550 http://dx.doi.org/10.7759/cureus.12559 |
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author | Efeoglu Sacak, Melis Karacabey, Sinan Sanri, Erkman Omercikoglu, Serhad Ünal, Emir Ecmel Onur, Özge Akoglu, Haldun Denizbasi, Arzu |
author_facet | Efeoglu Sacak, Melis Karacabey, Sinan Sanri, Erkman Omercikoglu, Serhad Ünal, Emir Ecmel Onur, Özge Akoglu, Haldun Denizbasi, Arzu |
author_sort | Efeoglu Sacak, Melis |
collection | PubMed |
description | Introduction: A cluster of atypical pneumonia cases in Wuhan, China, turned out to be a highly contagious disease, swept across most of the countries, and soon after was announced as a pandemic. Therefore we aimed to investigate the demographics and factors associated with the disease outcome. Methods: In this retrospective chart review, we screened patients admitted to the emergency department with severe acute respiratory infection due to coronavirus disease 2019 (COVID-19) between March 15, 2020 and April 30, 2020. Age, gender, symptoms, laboratory data, and radiology data were obtained, as well as outcomes and length of stay. Results: We identified 177 patients (54.8% male). Seventy-eight percent of the cases were admitted into wards whereas 22% of the cases were admitted into the intensive care unit (ICU). Twenty-five percent of the cases needed invasive mechanical ventilation during their hospital stay and median length of hospital stay until death or discharge was eight days (interquartile range (IQR) 5.0 - 16.0). Among 177 patients, overall in-hospital mortality rate was 19.8% (n=35; male:female=18:17; p=0.6553). In-hospital mortality rates were statistically significantly higher in patients with higher age (64 vs. 74; p=0.0091), respiratory rate (RR) (28 vs. 36; p=0.0002), C-reactive protein (CRP) (54.7 vs. 104.0; p<0.0001), d-dimer (1.2 vs. 3.2; p<0.0001), ferritin (170 vs. 450.4; p<0.0001), fibrinogen (512 vs. 598; p=0.0349), international normalized ratio (INR) (1.1 vs. 1.3; p=0.0001), prothrombin time (PT) (14.8 vs. 17.4; p=0.0001), procalcitonin (0.1 vs. 0.3; p<0.0001), creatinine (0.9 vs. 1.1; p=0.0084), longer length of stay (LOS) (8.0 vs. 13.0; p=0.0251) with lower oxygen saturation (sO(2)) (93.0% vs 87.5%; p<0.0001), diastolic blood pressure (DBP) (78 vs. 70; p=0.0039), lymphocyte (1.2 vs. 0.8; p=0.0136), and with positive polymerase chain reaction (PCR) results (28.6% vs. 12.8%; p=0.0118). Conclusion: Patients with older age, higher RR, lower sO(2) and DBP, higher creatinine, d-dimer, INR, CRP, procalcitonin, ferritin, and fibrinogen on initial admission were found to be less likely to survive COVID-19. |
format | Online Article Text |
id | pubmed-7863081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-78630812021-02-08 Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department Efeoglu Sacak, Melis Karacabey, Sinan Sanri, Erkman Omercikoglu, Serhad Ünal, Emir Ecmel Onur, Özge Akoglu, Haldun Denizbasi, Arzu Cureus Emergency Medicine Introduction: A cluster of atypical pneumonia cases in Wuhan, China, turned out to be a highly contagious disease, swept across most of the countries, and soon after was announced as a pandemic. Therefore we aimed to investigate the demographics and factors associated with the disease outcome. Methods: In this retrospective chart review, we screened patients admitted to the emergency department with severe acute respiratory infection due to coronavirus disease 2019 (COVID-19) between March 15, 2020 and April 30, 2020. Age, gender, symptoms, laboratory data, and radiology data were obtained, as well as outcomes and length of stay. Results: We identified 177 patients (54.8% male). Seventy-eight percent of the cases were admitted into wards whereas 22% of the cases were admitted into the intensive care unit (ICU). Twenty-five percent of the cases needed invasive mechanical ventilation during their hospital stay and median length of hospital stay until death or discharge was eight days (interquartile range (IQR) 5.0 - 16.0). Among 177 patients, overall in-hospital mortality rate was 19.8% (n=35; male:female=18:17; p=0.6553). In-hospital mortality rates were statistically significantly higher in patients with higher age (64 vs. 74; p=0.0091), respiratory rate (RR) (28 vs. 36; p=0.0002), C-reactive protein (CRP) (54.7 vs. 104.0; p<0.0001), d-dimer (1.2 vs. 3.2; p<0.0001), ferritin (170 vs. 450.4; p<0.0001), fibrinogen (512 vs. 598; p=0.0349), international normalized ratio (INR) (1.1 vs. 1.3; p=0.0001), prothrombin time (PT) (14.8 vs. 17.4; p=0.0001), procalcitonin (0.1 vs. 0.3; p<0.0001), creatinine (0.9 vs. 1.1; p=0.0084), longer length of stay (LOS) (8.0 vs. 13.0; p=0.0251) with lower oxygen saturation (sO(2)) (93.0% vs 87.5%; p<0.0001), diastolic blood pressure (DBP) (78 vs. 70; p=0.0039), lymphocyte (1.2 vs. 0.8; p=0.0136), and with positive polymerase chain reaction (PCR) results (28.6% vs. 12.8%; p=0.0118). Conclusion: Patients with older age, higher RR, lower sO(2) and DBP, higher creatinine, d-dimer, INR, CRP, procalcitonin, ferritin, and fibrinogen on initial admission were found to be less likely to survive COVID-19. Cureus 2021-01-07 /pmc/articles/PMC7863081/ /pubmed/33564550 http://dx.doi.org/10.7759/cureus.12559 Text en Copyright © 2021, Efeoglu Sacak et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Emergency Medicine Efeoglu Sacak, Melis Karacabey, Sinan Sanri, Erkman Omercikoglu, Serhad Ünal, Emir Ecmel Onur, Özge Akoglu, Haldun Denizbasi, Arzu Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department |
title | Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department |
title_full | Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department |
title_fullStr | Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department |
title_full_unstemmed | Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department |
title_short | Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department |
title_sort | variables affecting mortality among covid-19 patients with lung involvement admitted to the emergency department |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863081/ https://www.ncbi.nlm.nih.gov/pubmed/33564550 http://dx.doi.org/10.7759/cureus.12559 |
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