Risk Factors of Fatal Outcome in Patients With COVID-19 Pneumonia

Cellina, Michaela; Gibelli, Daniele; Valenti Pittino, Carlo; Toluian, Tahereh; Marino, Pietro; Oliva, Giancarlo

OBJECTIVES: The aim of this study was to correlate the clinical, laboratory, and radiographic characteristics of patients with a confirmed diagnosis of coronavirus disease 2019 (COVID-19) disease, with fatal outcome. METHODS: We reviewed chest X-ray (CXR) features, clinical, and laboratory data of patients with reverse transcriptase polymerase-chain-reaction confirmed diagnosis of COVID-19 infection. The relationship with mortality was investigated by fitting a logistic regression model. RESULTS: A total of 246 patients were included (170 males; mean age, 63 y). Most of the patients had 1 or more comorbidity (62%); fever (95%), and cough (60%) were the most common symptoms; CXR detected abnormalities in 88.6%, mainly showing ground-glass opacities (GGO) (90%) with bilateral (64%) and peripheral (46%) distribution. Multivariate analysis showed that age (P < 0.001; mortality of 59% in patients >66 y old; 5% at a younger age) and consolidation at CXR (P = 0.001; mortality of 11% with positive CXR; 2% in those without) represented the 2 most significant independent risk factors of mortality. Chronic pathologies, such as diabetes and chronic obstructive pulmonary disease, and peripheral GGO at CXR also showed a significant correlation with mortality. CONCLUSIONS: We identified predictive factors for the fatal outcome of COVID-19 patients. The prognostic value of these findings can be useful for optimal patient management and resource allocation.