Predictors for Early and Late Death in Adult Patients with COVID-19: A Cohort Study

Abstract

The timing of death in patients with coronavirus disease 2019 (COVID-19) varied by their comorbidities and severity of illness. However, few studies have determined predictors of mortality with respect to the timing of death in infectious patients. This cohort study aimed to identify the factors associated with early and late death in hospitalized COVID-19 patients. From 14 May to 31 July 2021, this study consecutively recruited laboratory-confirmed COVID-19 patients admitted to Taipei City Hospital. All patients with COVID-19 were followed up until death or discharge from the hospital or till 13 August 2021. Mortality in such patients was categorized as early death (death within the first two weeks of hospitalization) or late death (mortality later than two weeks after hospitalization), based on the timing of death. Multinomial logistic regression was used to determine the factors associated with early and late death among such patients. Of 831 recruited patients, the overall mean age was 59.3 years, and 12.2% died during hospitalization. Of the 101 deceased, 66 (65.3%) and 35 (34.7%) died early and late, respectively. After adjusting for demographics and comorbidities, independent predictors for early death included age ≥ 65 years (adjusted odds ratio (AOR) = 5.27; 95% confidence interval (CI): 2.88-9.65), heart failure (AOR = 10.32; 95% CI: 2.28-46.65), and end-stage renal disease (AOR = 11.97; 95% CI: 3.53-40.55). This study found that two thirds of COVID-19 deaths occurred within two weeks of hospitalization. It suggests that hospitalized patients with COVID-19 should be treated carefully and monitored closely for the progression of clinical conditions during treatment, particularly in older patients and in those with comorbidities.

Keywords: COVID-19; mortality; prospective study; timing of death.

Figure 1

The process of enrollment in patients with COVID-19 infection.