Predictors of mortality, ICU hospitalization, and extrapulmonary complications in COVID-19 patients - 02/09/21
, M. Eyriey b, S. Gravier a, T. Bonijoly a, D. Kayser a, C. Ion a, M. Mohseni-Zadeh a, S. Camara b, J. Dubois b, E. Haerrel b, J. Drouaine b, J. Kaiser b, c, J.C. Ongagna b, A. Schieber-Pachart b, C. Kempf bthe Centre Alsace COVID-19 Study Group1
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Highlights |
• | In March 2020, 25% of patients with COVID-19 were admitted to the intensive care unit (ICU) and 19% died. |
• | The main clinical factors associated with death were age and neurological or renal disease. |
• | The main biological factors associated with death were high CRP and creatinine levels, and low hemoglobin levels. |
• | The main complications were kidney and liver failure, cardiac and thromboembolism events. |
• | Most extrapulmonary complications occurred in ICU patients. |
Abstract |
Objective |
A major coronavirus disease 2019 (COVID-19) outbreak occurred in Northeastern France in spring 2020. This single-center retrospective observational cohort study aimed to compare patients with severe COVID-19 and those with non-severe COVID-19 (survivors vs. non-survivors, ICU patients vs. non-ICU patients) and to describe extrapulmonary complications.
Patients and methods |
We included all patients with a confirmed diagnosis of COVID-19 admitted to Colmar Hospital in March 2020.
Results |
We examined 600 patients (median age 71.09 years; median body mass index: 26.9 kg/m2); 57.7% were males, 86.3% had at least one comorbidity, 153 (25.5%) required ICU hospitalization, and 115 (19.1%) died. Baseline independent factors associated with death were older age (>75 vs. ≤75 years), male sex, oxygen supply, chronic neurological, renal, and pulmonary diseases, diabetes, cancer, low platelet and hemoglobin counts, and high levels of C-reactive protein (CRP) and serum creatinine. Factors associated with ICU hospitalization were age <75 years, oxygen supply, chronic pulmonary disease, absence of dementia, and high levels of CRP, hemoglobin, and serum creatinine. Among the 600 patients, 80 (13.3%) had an acute renal injury, 33 (5.5%) had a cardiovascular event, 27 (4.5%) had an acute liver injury, 24 (4%) had venous thromboembolism, eight (1.3%) had a neurological event, five (0.8%) had rhabdomyolysis, and one had acute pancreatitis. Most extrapulmonary complications occurred in ICU patients.
Conclusion |
This study highlighted the main risk factors for ICU hospitalization and death caused by severe COVID-19 and the frequency of numerous extrapulmonary complications in France.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, SARS-CoV-2, Outcome, Extrapulmonary COVID-19, Mortality
Plan
Vol 51 - N° 6
P. 518-525 - septembre 2021 Retour au numéro
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