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288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania

BACKGROUND: Till May 2022 there were 1.06 million of COVID-19 cases and 9108 deaths caused by COVID-19 disease registered in Lithuania. The objective of the study was to evaluate prognostic factors for in-hospital mortality of patients with severe COVID-19 disease. METHODS: COVID-19 positive adult p...

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Autores principales: Kubiliute, Ieva, Urboniene, Jurgita, Rudenaite, Akvile, Zablockiene, Birute, Gefenaite, Giedre, Jancoriene, Ligita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751558/
http://dx.doi.org/10.1093/ofid/ofac492.366
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author Kubiliute, Ieva
Urboniene, Jurgita
Rudenaite, Akvile
Zablockiene, Birute
Gefenaite, Giedre
Jancoriene, Ligita
author_facet Kubiliute, Ieva
Urboniene, Jurgita
Rudenaite, Akvile
Zablockiene, Birute
Gefenaite, Giedre
Jancoriene, Ligita
author_sort Kubiliute, Ieva
collection PubMed
description BACKGROUND: Till May 2022 there were 1.06 million of COVID-19 cases and 9108 deaths caused by COVID-19 disease registered in Lithuania. The objective of the study was to evaluate prognostic factors for in-hospital mortality of patients with severe COVID-19 disease. METHODS: COVID-19 positive adult patients hospitalized in Vilnius University Hospital Santaros Klinikos, Lithuania, were included in the cohort study between March 2020 and December 2021. Medical history, vital signs were collected, laboratory tests, chest X-ray were performed. Severe COVID-19 disease was defined as pneumonia with objective respiratory failure symptoms. ROC curve was used to evaluate prognostic value of a laboratory test, multivariable logistic regression was used to determine the prognostic factors for in-hospital lethal outcome. p-value < 0.05 was considered significant. RESULTS: Severe COVID-19 disease was diagnosed for 291 participants, 21 (7.2%) of them died. Hematological, lung diseases and cancer were more common among patients who died compared to those who recovered (Table 1). Patients who died were older, more frequently had confusion (25.0% vs 5.2%, p=0.001), tachypnea (57.1% vs 26.7%, p=0.003), and dyspnea (81.0% vs 54.1%, p=0.017), their time median from symptoms onset to admission was shorter (2.5 (IQR 0-7) vs 7 (IQR 4-9) days, p< 0.001) compared those who recovered. On admission, patients who died had lower lymphocytes count, higher neutrophiles count and higher concentration of aspartate aminotransferase (AST), lactate, creatinine and urea compared to those who recovered. The best prognostic features for lethal outcome possessed neutrophiles count, AST, lactate, creatinine and urea (Figure 1). Optimal cut-off values were calculated and included into multivariable regression model. Multivariable regression revealed that hematological diseases (OR 8.68; 95% CI 1.46-51.40, p=0.017), initial AST > 32.9 U/l (OR 13.57; 95% CI 1.46-125.94, p=0.022), lactate > 1.46 mmol/l (OR 4.87; 95% CI 1.03-22.86, p=0.045) were associated with in-hospital mortality of patients with severe COVID-19 adjusted for age. [Figure: see text] [Figure: see text] CONCLUSION: Hematological diseases, elevated AST and lactate are significant prognostic factors for in-hospital mortality of patients with severe COVID-19 disease at earlier stages of disease. DISCLOSURES: All Authors: No reported disclosures.
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spelling pubmed-97515582022-12-16 288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania Kubiliute, Ieva Urboniene, Jurgita Rudenaite, Akvile Zablockiene, Birute Gefenaite, Giedre Jancoriene, Ligita Open Forum Infect Dis Abstracts BACKGROUND: Till May 2022 there were 1.06 million of COVID-19 cases and 9108 deaths caused by COVID-19 disease registered in Lithuania. The objective of the study was to evaluate prognostic factors for in-hospital mortality of patients with severe COVID-19 disease. METHODS: COVID-19 positive adult patients hospitalized in Vilnius University Hospital Santaros Klinikos, Lithuania, were included in the cohort study between March 2020 and December 2021. Medical history, vital signs were collected, laboratory tests, chest X-ray were performed. Severe COVID-19 disease was defined as pneumonia with objective respiratory failure symptoms. ROC curve was used to evaluate prognostic value of a laboratory test, multivariable logistic regression was used to determine the prognostic factors for in-hospital lethal outcome. p-value < 0.05 was considered significant. RESULTS: Severe COVID-19 disease was diagnosed for 291 participants, 21 (7.2%) of them died. Hematological, lung diseases and cancer were more common among patients who died compared to those who recovered (Table 1). Patients who died were older, more frequently had confusion (25.0% vs 5.2%, p=0.001), tachypnea (57.1% vs 26.7%, p=0.003), and dyspnea (81.0% vs 54.1%, p=0.017), their time median from symptoms onset to admission was shorter (2.5 (IQR 0-7) vs 7 (IQR 4-9) days, p< 0.001) compared those who recovered. On admission, patients who died had lower lymphocytes count, higher neutrophiles count and higher concentration of aspartate aminotransferase (AST), lactate, creatinine and urea compared to those who recovered. The best prognostic features for lethal outcome possessed neutrophiles count, AST, lactate, creatinine and urea (Figure 1). Optimal cut-off values were calculated and included into multivariable regression model. Multivariable regression revealed that hematological diseases (OR 8.68; 95% CI 1.46-51.40, p=0.017), initial AST > 32.9 U/l (OR 13.57; 95% CI 1.46-125.94, p=0.022), lactate > 1.46 mmol/l (OR 4.87; 95% CI 1.03-22.86, p=0.045) were associated with in-hospital mortality of patients with severe COVID-19 adjusted for age. [Figure: see text] [Figure: see text] CONCLUSION: Hematological diseases, elevated AST and lactate are significant prognostic factors for in-hospital mortality of patients with severe COVID-19 disease at earlier stages of disease. DISCLOSURES: All Authors: No reported disclosures. Oxford University Press 2022-12-15 /pmc/articles/PMC9751558/ http://dx.doi.org/10.1093/ofid/ofac492.366 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Kubiliute, Ieva
Urboniene, Jurgita
Rudenaite, Akvile
Zablockiene, Birute
Gefenaite, Giedre
Jancoriene, Ligita
288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania
title 288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania
title_full 288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania
title_fullStr 288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania
title_full_unstemmed 288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania
title_short 288. Prognostic Factors for In-hospital Mortality of Patients with Severe COVID-19 Hospitalized in the University Medical Center, Lithuania
title_sort 288. prognostic factors for in-hospital mortality of patients with severe covid-19 hospitalized in the university medical center, lithuania
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751558/
http://dx.doi.org/10.1093/ofid/ofac492.366
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