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Prognostic parameters of in‐hospital mortality in COVID‐19 patients—An Italian experience
Author(s) -
Ruscica Massimiliano,
Macchi Chiara,
Iodice Simona,
Tersalvi Gregorio,
Rota Irene,
Ghidini Simone,
Terranova Leonardo,
Valenti Luca,
Amati Francesco,
Aliberti Stefano,
Corsini Alberto,
Blasi Francesco,
Carugo Stefano,
Bollati Valentina,
Vicenzi Marco
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13629
Subject(s) - medicine , hazard ratio , covid-19 , proportional hazards model , intensive care unit , natriuretic peptide , lactate dehydrogenase , outbreak , confidence interval , disease , virology , heart failure , biochemistry , chemistry , infectious disease (medical specialty) , enzyme
Background During COVID‐19 outbreak, Italy was the first country in Europe to be heavily affected with an intensive care unit mortality of 26%. In order to reduce this percentage, physicians should establish clear and objective criteria to stratify COVID‐19 patients at high risk of in‐hospital death. Thus, the aim has been to test a large spectrum of variables ranging from clinical evaluation to laboratory biomarkers to identify which parameter would best predict all‐cause in‐hospital mortality in COVID‐19 patients. Design observational study. Results Multivariate Cox regression analysis showed that each 5 years of increase in age corresponded to a hazard ratio (HR) of 1.28 (95% CI 1.00‐1.65, P = .050); each increment of 803 ng/L of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) corresponded to a HR of 1.24 (95% CI 1.11‐1.39, P < .001); each increment of 58 ng/L of interleukin (IL)‐6 corresponded to a HR of 1.23 (95% CI 1.09‐1.40, P < .001), and each increment of 250 U/L of lactate dehydrogenase (LDH) corresponded to a HR of 1.23 (95% CI 1.10‐1.37, P < .001). According to the calculated cut‐points for age (≥70 years), NT‐proBNP (≥803 ng/L), IL‐6 (≥58 ng/L) and LDH (≥371 U/L) when 2 out of these 4 were overcome, the HR was 2.96 (95% CI 1.97‐4.45, P < .001). Conclusion In COVID‐19 patients, besides age, the evaluation of three biochemical parameters, available in few hours after hospital admission can predict in‐hospital mortality regardless of other comorbidities.