Risk factors for mortality among patients with SARS‐CoV‐2 infection: A longitudinal observational study

Almaghlouth, Nouf K; Davis, Monique G; Davis, Michelle A; Anyiam, Felix E; Guevara, Roberto; Antony, Suresh J

BACKGROUND: Recent literature suggests that approximately 5‐18% of patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may progress rapidly to a severe form of the illness and subsequent death. We examined the relationship between sociodemographic, clinical, and laboratory findings with mortality among patients. METHODS: In this study, 112 patients were evaluated from February‐May 2020 and 80 patients met the inclusion criteria. Tocilizumab (TCZ) was administered, followed by methylprednisolone to patients with pneumonia severity index (PSI) score ≤ 130 and CT scan changes. Demographic data and clinical outcomes were collected. Laboratory biomarkers were monitored during hospitalization. Statistical analyses were performed with significance p≤ 0.05. RESULTS: Eighty (80) patients: 45 males (56.25%) and 35 females (43.75%) met the study inclusion criteria. Seven patients (8.75%) were deceased. An increase in mortality outcome was statistically significantly associated with higher average levels of IL‐6 with P value (0.050), and D‐dimer with P value (0.024). Bivariate logistics regression demonstrated a significant increased odds for mortality for patients with bacterial lung infections (OR: 10.83, 95% CI: 2.05 – 57.40, P=0.005) and multi‐organ damage (OR: 103.50, 95% CI: 9.92 – 1079.55, P=0.001). Multivariate logistics regression showed a statistically significant association for multi‐organ damage (AOR: 94.17, 95% CI: 7.39 ‐ 1200.78, P=0.001). CONCLUSIONS: We identified three main predictors for high mortality. These include interleukin‐6 (IL‐6), D‐dimer, and multi‐organ damage. The latter was the highest potential risk for in‐hospital deaths. This warrants aggressive health measures for early recognition of the problem and initiation of treatment to reverse injuries. This article is protected by copyright. All rights reserved.