Clinical characteristics of COVID-19 hospitalized patients associated with mortality: A cohort study in Spain

Abstract

Background: The heterogeneity of patients with COVID-19 may explain the wide variation of mortality rate due to the population characteristics, presence of comorbidities and clinical manifestations.

Methods: In this study, we analyzed 5342 patients' recordings and selected a cohort of 177 hospitalized patients with a poor prognosis at an early stage. We assessed during 6 months their symptomatology, coexisting health conditions, clinical measures and health assistance related to mortality. Multiple Cox proportional hazards models were built to identify the associated factors with mortality risk.

Results: We observed that cough and kidney failure triplicate the mortality risk and both bilirubin levels and oncologic condition are shown as the most associated with the demise, increasing in four and ten times the risk, respectively. Other clinical characteristics such as fever, diabetes mellitus, breathing frequency, neutrophil-lymphocyte ratio, oxygen saturation, and troponin levels, were also related to mortality risk of in-hospital death.

Conclusions: The present study shows that some symptomatology, comorbidities and clinical measures could be the target of prevention tools to improve survival rates.

Keywords: COVID-19; Coronavirus infections; Epidemiology; Mortality; Pandemics; Proportional hazard model; Respiratory insufficiency; SARS-CoV-2.

Fig. 1

Forest plot of estimated effects of symptomatology, coexisting health conditions, clinical measures and health assistance on mortality risk, in the multiple Cox proportional hazards model (n = 177).