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Laboratory findings and a combined multifactorial approach to predict death in critically ill patients with COVID-19: a retrospective study.
Epidemiol Infect. 2020 06 30; 148:e129.EI

Abstract

To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. Single variable and multivariable logistic regression analyses were performed to identify mortality-related factors. We combined multiple factors to predict mortality, which was validated by receiver operating characteristic curves. As a result, in a total of 336 patients, 34 (10.1%) patients died during hospitalisation. Through multivariable logistic regression, we found that decreased lymphocyte ratio (Lymr, %) (odds ratio, OR 0.574, P < 0.001), elevated blood urea nitrogen (BUN) (OR 1.513, P = 0.009), and raised D-dimer (DD) (OR 1.334, P = 0.002) at admission were closely related to death. The combined prediction model was developed by these factors with a sensitivity of 100.0% and specificity of 97.2%. In conclusion, decreased Lymr, elevated BUN, and raised DD were found to be in association with death outcomes in critically ill patients with COVID-19. A scoring system was developed to predict the clinical outcome of these patients.

Authors+Show Affiliations

Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

32600484

Citation

Liu, Q, et al. "Laboratory Findings and a Combined Multifactorial Approach to Predict Death in Critically Ill Patients With COVID-19: a Retrospective Study." Epidemiology and Infection, vol. 148, 2020, pp. e129.
Liu Q, Song NC, Zheng ZK, et al. Laboratory findings and a combined multifactorial approach to predict death in critically ill patients with COVID-19: a retrospective study. Epidemiol Infect. 2020;148:e129.
Liu, Q., Song, N. C., Zheng, Z. K., Li, J. S., & Li, S. K. (2020). Laboratory findings and a combined multifactorial approach to predict death in critically ill patients with COVID-19: a retrospective study. Epidemiology and Infection, 148, e129. https://doi.org/10.1017/S0950268820001442
Liu Q, et al. Laboratory Findings and a Combined Multifactorial Approach to Predict Death in Critically Ill Patients With COVID-19: a Retrospective Study. Epidemiol Infect. 2020 06 30;148:e129. PubMed PMID: 32600484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laboratory findings and a combined multifactorial approach to predict death in critically ill patients with COVID-19: a retrospective study. AU - Liu,Q, AU - Song,N C, AU - Zheng,Z K, AU - Li,J S, AU - Li,S K, Y1 - 2020/06/30/ PY - 2020/7/1/pubmed PY - 2020/7/29/medline PY - 2020/7/1/entrez KW - Blood urea nitrogen (BUN) KW - D-dimer (DD) KW - coronavirus disease 2019 (COVID-19) KW - death KW - lymphocyte ratio SP - e129 EP - e129 JF - Epidemiology and infection JO - Epidemiol Infect VL - 148 N2 - To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. Single variable and multivariable logistic regression analyses were performed to identify mortality-related factors. We combined multiple factors to predict mortality, which was validated by receiver operating characteristic curves. As a result, in a total of 336 patients, 34 (10.1%) patients died during hospitalisation. Through multivariable logistic regression, we found that decreased lymphocyte ratio (Lymr, %) (odds ratio, OR 0.574, P < 0.001), elevated blood urea nitrogen (BUN) (OR 1.513, P = 0.009), and raised D-dimer (DD) (OR 1.334, P = 0.002) at admission were closely related to death. The combined prediction model was developed by these factors with a sensitivity of 100.0% and specificity of 97.2%. In conclusion, decreased Lymr, elevated BUN, and raised DD were found to be in association with death outcomes in critically ill patients with COVID-19. A scoring system was developed to predict the clinical outcome of these patients. SN - 1469-4409 UR - https://www.unboundmedicine.com/medline/citation/32600484/Laboratory_findings_and_a_combined_multifactorial_approach_to_predict_death_in_critically_ill_patients_with_COVID_19:_a_retrospective_study_ L2 - https://www.cambridge.org/core/product/identifier/S0950268820001442/type/journal_article DB - PRIME DP - Unbound Medicine ER -