Risk factors and outcomes for acute respiratory failure in coronavirus disease 2019: An observational cohort study.

Piwowarczyk, Paweł; Szczukocka, Marta; Kutnik, Paweł; Borys, Michał; Mikłaszewska, Anna; Kiciak, Sławomir; Czuczwar, Mirosław

BACKGROUND The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread throughout Europe. However, there is a lack of data on the full clinical course of patients infected with SARS-CoV-2 in Europe, especially in the population that developed acute respiratory failure (ARF). OBJECTIVES To identify risk factors associated with developing ARF during SARS-CoV-2 infection. MATERIAL AND METHODS This was an observational study of 60 adult patients with laboratory-confirmed SARS-CoV-2 infection. Data were collected from March 26, 2020 to May 26, 2020 in a tertiary academic hospital in Poland. All patients reached final outcome (discharge from the hospital or death). We divided patients into 2 groups based on whether they developed ARF, compared their clinical data, and performed multivariate logistic regression. RESULTS Twenty-two patients (36%) from the observed cohort developed ARF. Logistic regression identified that a high sequential organ failure assessment score at admission (odds ratio (OR) = 6.97 (1.57-30.90, p = 0.011)), and a long time from admission until pneumonia (OR = 1.41 (1.06-1.87, p = 0.016)), correlated with ARF development. D-dimer, lactate dehydrogenase, neutrophil to lymphocyte ratio, C-reactive protein (CRP), and interleukin 6 (IL-6) differed both statistically and clinically between ARF and non-ARF groups. The mortality rate in the observed cohort of patients was 13.3%, and it was 32% in the group that developed ARF. CONCLUSIONS Routine vigilant examination of the above markers may identify patients at the highest risk of ARF early on during COVID-19 infection.