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Observational Study
. 2021 Sep;51(6):518-525.
doi: 10.1016/j.idnow.2021.07.002. Epub 2021 Jul 7.

Predictors of mortality, ICU hospitalization, and extrapulmonary complications in COVID-19 patients

M Martinot  1 , M Eyriey  2 , S Gravier  3 , T Bonijoly  3 , D Kayser  3 , C Ion  3 , M Mohseni-Zadeh  3 , S Camara  2 , J Dubois  2 , E Haerrel  2 , J Drouaine  2 , J Kaiser  4 , J C Ongagna  2 , A Schieber-Pachart  2 , C Kempf  2 ; Centre Alsace COVID-19 Study Group
Affiliations
Observational Study

Predictors of mortality, ICU hospitalization, and extrapulmonary complications in COVID-19 patients

M Martinot et al. Infect Dis Now. 2021 Sep.

Abstract

Objective: A major coronavirus disease 2019 (COVID-19) outbreak occurred in Northeastern France in spring 2020. This single-center retrospective observational cohort study aimed to compare patients with severe COVID-19 and those with non-severe COVID-19 (survivors vs. non-survivors, ICU patients vs. non-ICU patients) and to describe extrapulmonary complications.

Patients and methods: We included all patients with a confirmed diagnosis of COVID-19 admitted to Colmar Hospital in March 2020.

Results: We examined 600 patients (median age 71.09 years; median body mass index: 26.9 kg/m2); 57.7% were males, 86.3% had at least one comorbidity, 153 (25.5%) required ICU hospitalization, and 115 (19.1%) died. Baseline independent factors associated with death were older age (>75 vs. ≤75 years), male sex, oxygen supply, chronic neurological, renal, and pulmonary diseases, diabetes, cancer, low platelet and hemoglobin counts, and high levels of C-reactive protein (CRP) and serum creatinine. Factors associated with ICU hospitalization were age <75 years, oxygen supply, chronic pulmonary disease, absence of dementia, and high levels of CRP, hemoglobin, and serum creatinine. Among the 600 patients, 80 (13.3%) had an acute renal injury, 33 (5.5%) had a cardiovascular event, 27 (4.5%) had an acute liver injury, 24 (4%) had venous thromboembolism, eight (1.3%) had a neurological event, five (0.8%) had rhabdomyolysis, and one had acute pancreatitis. Most extrapulmonary complications occurred in ICU patients.

Conclusion: This study highlighted the main risk factors for ICU hospitalization and death caused by severe COVID-19 and the frequency of numerous extrapulmonary complications in France.

Keywords: COVID-19; Extrapulmonary COVID-19; Mortality; Outcome; SARS-CoV-2.

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Figures

Fig. 1
Fig. 1
Death rate curve–Product limit estimate (Kaplan–Meier) with two-sided confidence interval and number of patients at risk. Day 0 is the day of hospitalization. Patients alive at the end of follow-up were censored at the date of last information.
Fig. 2
Fig. 2
Results of the multivariate logistic regression analysis of death (left) and ICU (right) presented as odds ratios with 95% confidence interval. All baseline variables significant at the 0.20 level were included in the model. Creat.: Creatinine; CRP: C-Reactive Protein.
Fig. 3
Fig. 3
Results of the multivariate logistic regression analysis of extrapulmonary event ([a] AKI, [b] ALI, [c] cardiac events, [d] thromboembolic events) presented as odds ratios with 95% confidence interval. All baseline variables significant at the 0.20 level were included in the models.
See this image and copyright information in PMC

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