Risk factors of fatal outcome in patients with COVID-19 pneumonia

Disaster Med Public Health Prep. 2020 Sep 10;1-30. doi: 10.1017/dmp.2020.346. Online ahead of print.

Abstract

Aim: To correlate the clinical, laboratory, and radiographic characteristics of patients with a confirmed diagnosis of COVID-19 disease, with fatal outcome.

Methods: We reviewed Chest X-Ray (CXR) features, clinical, and laboratory data of patients with RT-PCR confirmed diagnosis of COVID-19 infection. The relationship with mortality was investigated by fitting a logistic regression model.

Results: 246 patients were included (170 males; mean age: 63). Most of the patients had one 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<.001; mortality of 59% in patients >66 years old; 5% at a younger age) and consolidation at CXR (p=.001; mortality of 11% with positive CXR; 2% in those without) represented the two 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 the right patient management and resource allocation.

Keywords: COVID-19; Patient Outcome Assessment; Pneumonia, Viral; Radiography; coronavirus disease.