CHEST Guidelines-Risk-Factors-of-Fatal-Outcome-in-Hospitalized-Subj (1)

Risk-Factors-of-Fatal-Outcome-in-Hospitalized-Subj (1)

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The study "Risk Factors of Fatal Outcome in Hospitalized Subjects with Coronavirus Disease 2019" conducted a nationwide analysis in China to identify factors associated with fatal outcomes in COVID-19 patients. The retrospective cohort study included 1,590 hospitalized patients and used multivariate Cox regression analysis to evaluate risk factors. It identified several independent risk factors that significantly increased the hazard ratio (HR) for fatal outcomes, including age (particularly those 75 and older, with HR 7.86), coronary heart disease (HR 4.28), cerebrovascular disease (HR 3.1), dyspnea (HR 3.96), elevated procalcitonin levels (HR 8.72), and high aspartate aminotransferase (AST) levels (HR 2.2). <br /><br />The study also developed a prognostic nomogram for predicting survival of COVID-19 patients, with high discriminatory power (C-index of 0.91). This tool can predict 14-, 21-, and 28-day overall survival probabilities based on individual risk factors. Calibration plots validated the consistency between predicted and observed outcomes.<br /><br />Findings indicated that older age was the strongest predictor of mortality. Moreover, pre-existing conditions like coronary heart disease and cerebrovascular disease significantly contributed to higher mortality. Laboratory findings such as elevated procalcitonin and AST levels were critical in the prediction model, suggesting bacterial infections at early stages could worsen clinical outcomes.<br /><br />While limitations included potential data inaccuracies due to the urgency of the pandemic and lack of validation cohort, the study highlighted key factors that could guide earlier and more intensive medical interventions, potentially improving patient outcomes. The study underscores the need for targeting high-risk groups, such as elderly individuals and those with underlying health conditions, with vigilant surveillance and tailored therapeutic strategies.

Keywords

COVID-19

fatal outcomes

risk factors

hospitalized patients

multivariate Cox regression

prognostic nomogram

elderly patients

coronary heart disease

cerebrovascular disease

elevated procalcitonin