Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID‐19 patients in Michigan, United States
| Autor: | O. Ibironke, Alexandra Halalau, A. Hanna, A. Vanood, D. O’Connor, Inayat Gill, Zaid Imam, A. Ranski, Fadi Odish, Justin Armstrong |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Michigan Multivariate analysis Coronavirus disease 2019 (COVID-19) Pneumonia Viral Comorbidity Outcomes 030204 cardiovascular system & hematology 03 medical and health sciences Betacoronavirus 0302 clinical medicine Age COVID‐19 Risk Factors Diabetes mellitus Internal medicine medicine Internal Medicine Diabetes Mellitus Prevalence Humans Hospital Mortality Survival rate Pandemics Retrospective Studies Inpatients business.industry SARS-CoV-2 Acute kidney injury Age Factors COVID-19 Disease Management Retrospective cohort study Middle Aged medicine.disease Prognosis Survival Rate 030104 developmental biology Cohort Hypertension RNA Viral Female business Coronavirus Infections Rapid Communication Follow-Up Studies |
| Zdroj: | Journal of Internal Medicine |
| ISSN: | 1365-2796 0954-6820 |
| Popis: | INTRODUCTION: Higher comorbidity and older age have been reported as correlates of poor outcomes in COVID-19 patients worldwide; however, US data are scarce. We evaluated mortality predictors of COVID-19 in a large cohort of hospitalized patients in the United States. DESIGN: Retrospective, multicenter cohort of inpatients diagnosed with COVID-19 by RT-PCR from 1 March to 17 April 2020 was performed, and outcome data evaluated from 1 March to 17 April 2020. Measures included demographics, comorbidities, clinical presentation, laboratory values and imaging on admission. Primary outcome was mortality. Secondary outcomes included length of stay, time to death and development of acute kidney injury in the first 48-h. RESULTS: The 1305 patients were hospitalized during the evaluation period. Mean age was 61.0 ± 16.3, 53.8% were male and 66.1% African American. Mean BMI was 33.2 ± 8.8 kg m-2 . Median Charlson Comorbidity Index (CCI) was 2 (1-4), and 72.6% of patients had at least one comorbidity, with hypertension (56.2%) and diabetes mellitus (30.1%) being the most prevalent. ACE-I/ARB use and NSAIDs use were widely prevalent (43.3% and 35.7%, respectively). Mortality occurred in 200 (15.3%) of patients with median time of 10 (6-14) days. Age > 60 (aOR: 1.93, 95% CI: 1.26-2.94) and CCI > 3 (aOR: 2.71, 95% CI: 1.85-3.97) were independently associated with mortality by multivariate analyses. NSAIDs and ACE-I/ARB use had no significant effects on renal failure in the first 48 h. CONCLUSION: Advanced age and an increasing number of comorbidities are independent predictors of in-hospital mortality for COVID-19 patients. NSAIDs and ACE-I/ARB use prior to admission is not associated with renal failure or increased mortality. |
| Databáze: | OpenAIRE |
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