Risk factors for mortality of coronavirus disease-2019 (COVID-19) patients in two centers of Hubei province, China: A retrospective analysis

• Published in: PloS one Vol. 16; no. 1; p. e0246030
• Main Authors: Zhang, Xiao-Bin, Hu, Lan, Ming, Quan, Wei, Xiao-Jie, Zhang, Zhen-Yu, Chen, Li-Da, Wang, Ming-Hui, Yao, Weng-Zhen, Huang, Qiu-Fen, Ye, Zhang-Qiang, Cai, Yu-Qing, Zeng, Hui-Qing
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.01.2021; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Biology and Life Sciences; C-reactive protein; Cause of Death; China; China - epidemiology; Comorbidity; Complications; Computed tomography; Coronaviridae; Coronaviruses; COVID-19; COVID-19 - epidemiology; Creatine; Creatine kinase; Critical care; Da Chen; Data collection; Disease Outbreaks; Disease transmission; Electronic health records; Electronic medical records; Erythrocyte sedimentation rate; Erythrocytes; Female; Health risks; Hospitalization; Humans; Kinases; L-Lactate dehydrogenase; Laboratories; Lactate dehydrogenase; Lactic acid; Male; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Pandemics; Patients; Physical Sciences; Pneumonia; Polymerase chain reaction; Procalcitonin; Prognosis; Renal function; Research and Analysis Methods; Respiratory diseases; Retrospective Studies; Risk analysis; Risk Factors; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Software; Teaching hospitals; Thorax; Tumor necrosis factor-TNF; Viral diseases; Yu Zhang; China; United States > US; Hubei China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0246030

Since the outbreak in late December 2019 in Wuhan, China, coronavirus disease-2019 (COVID-19) has become a global pandemic. We analyzed and compared the clinical, laboratory, and radiological characteristics between survivors and non-survivors and identify risk factors for mortality. Clinical and laboratory variables, radiological features, treatment approach, and complications were retrospectively collected in two centers of Hubei province, China. Cox regression analysis was conducted to identify the risk factors for mortality. A total of 432 patients were enrolled, and the median patient age was 54 years. The overall mortality rate was 5.09% (22/432). As compared with the survivor group (n = 410), those in the non-survivor group (n = 22) were older, and they had a higher frequency of comorbidities and were more prone to suffer from dyspnea. Several abnormal laboratory variables indicated that acute cardiac injury, hepatic damage, and acute renal insufficiency were detected in the non-survivor group. Non-surviving patients also had a high computed tomography (CT) score and higher rate of consolidation. The most common complication causing death was acute respiratory distress syndrome (ARDS) (18/22, 81.8%). Multivariate Cox regression analysis revealed that hemoglobin (Hb) <90 g/L (hazard ratio, 10.776; 95% confidence interval, 3.075-37.766; p<0.0001), creatine kinase (CK-MB) >8 U/L (9.155; 2.424-34.584; p = 0.001), lactate dehydrogenase (LDH) >245 U/L (5.963; 2.029-17.529; p = 0.001), procalcitonin (PCT) >0.5 ng/ml (7.080; 1.671-29.992; p = 0.008), and CT score >10 (39.503; 12.430-125.539; p<0.0001) were independent risk factors for the mortality of COVID-19. Low Hb, high LDH, PCT, and CT score on admission were the predictors for mortality and could assist clinicians in early identification of poor prognosis among COVID-19 patients.