Inflammation-associated factors for predicting in-hospital mortality in patients with COVID-19.

Wang, Jun-Hong; Chen, Ru-Dong; Yang, Hong-Kuan; Zeng, Ling-Cheng; Chen, Hao; Hou, Yu-Yang; Hu, Wei; Yu, Jia-Sheng; Li, Hua

OBJECTIVES To explore the relation between inflammation-associated factors and in-hospital mortality and investigate which factor is an independent predictor of in-hospital death in patients with coronavirus disease-2019. METHODS This study included patients with coronavirus disease-2019 who were hospitalized between February 9, 2020, and March 30, 2020. Univariate Cox regression analysis and least absolute shrinkage and selection operator regression (LASSO) were used to select variables. Multivariate Cox regression analysis was applied to identify independent risk factors in coronavirus disease-2019. RESULTS 1135 patients were analysed during the study period. A total of 35 variables were considered to be risk factors after the univariate regression analysis of the clinical characteristics and laboratory parameters (p < 0.05), and LASSO regression analysis screened out seven risk factors for further study. The six independent risk factors revealed by multivariate Cox regression were myoglobin (HR 5.353, 95% CI 2.633-10.882; p < 0.001), C-reactive protein (HR 2.063, 95% CI 1.036-4.109; p = 0.039), neutrophil count (HR 2.015, 95% CI 1.154-3.518; p = 0.014), interleukin 6 (HR 9.753, 95% CI 2.952-32.218; p < 0.001), age (HR 2.016, 95% CI 1.077-3.773; p = 0.028), and international normalized ratio (HR 2.595, 95% CI 1.412-4.769; p = 0.002). CONCLUSION Our results suggested that inflammation-associated factors were significantly associated with in-hospital mortality in coronavirus disease-2019 patients. C-reactive protein, neutrophil count and interleukin 6 were independent factors for predicting in-hospital mortality and had a better independent predictive ability. We believe these findings may allow early identification of the patients at high risk for death, and can also assist better management of these patients. This article is protected by copyright. All rights reserved.