tetano
Editor, Senior Moderator
Ann Transl Med
. 2021 Feb;9(4):276.
doi: 10.21037/atm-20-4877.
Risk factors for mortality due to COVID-19 in intensive care units: a single-center study
Yu Chen[SUP] 1 [/SUP], Zhengyin Liu[SUP] 2 [/SUP], Xiaogang Li[SUP] 3 [/SUP], Jing Zhao[SUP] 4 [/SUP], Dong Wu[SUP] 5 [/SUP], Meng Xiao[SUP] 1 [/SUP], Dong Zhang[SUP] 1 [/SUP], Peng Gao[SUP] 6 [/SUP], Ran Tian[SUP] 6 [/SUP], Jing Xie[SUP] 2 [/SUP], Siyuan Fan[SUP] 7 [/SUP], Binbin Li[SUP] 8 [/SUP], Yingchun Xu[SUP] 1 [/SUP], Yongzhe Li[SUP] 1 [/SUP], Shuyang Zhang[SUP] 6 [/SUP]
Affiliations
Abstract
Background: Many studies have revealed several risk factors associated with the prognosis of patients with coronavirus disease 2019 (COVID-19), but the risk factors associated with death in critically ill COVID-19 patients still needs to be fully elucidated. Therefore, we analyzed clinical characteristics and laboratory data of ICU patients to identify risk factors associated with COVID-19 death.
Methods: Patients with COVID-19 from the ICU in the Sino-French New City Branch of Tongji Hospital Wuhan, China, between February 4 and February 29, 2020, were enrolled in this study. The final date of follow-up was April 4, 2020. Clinical manifestations, laboratory tests, treatment, and outcome of participants before and during the ICU stay were retrospectively collected and analyzed.
Results: A total of 92 patients were admitted or transferred to the ICU from February 4 to February 29, 2020. Compared to survivors, the majority of non-survivors (73.8%) presented with dyspnea. A random forest classifier and ROC curve were used to develop a predictive model. IL-6, D-dimer, lymphocytes, and albumin achieved good performance with AUCs of 0.9476, 0.9165, 0.8994, and 0.9251, respectively, which were consistent with clinical observations, such as inflammation, lymphopenia, and coagulation dysfunction. Combining IL-6 and D-dimer improved the performance of this model with an excellent AUC (0.997).
Conclusions: Mortality in COVID-19 was not rare in critically ill patients. The model that combined IL-6 and D-dimer was valuable for predicting the mortality of patients with COVID-19 with excellent performance. This model needs to be further optimized by adding more indicators and then evaluated with a multicenter study.
Keywords: Coronavirus disease 2019 (COVID-19); biomarkers; mortality; predictive model; risk factors.
. 2021 Feb;9(4):276.
doi: 10.21037/atm-20-4877.
Risk factors for mortality due to COVID-19 in intensive care units: a single-center study
Yu Chen[SUP] 1 [/SUP], Zhengyin Liu[SUP] 2 [/SUP], Xiaogang Li[SUP] 3 [/SUP], Jing Zhao[SUP] 4 [/SUP], Dong Wu[SUP] 5 [/SUP], Meng Xiao[SUP] 1 [/SUP], Dong Zhang[SUP] 1 [/SUP], Peng Gao[SUP] 6 [/SUP], Ran Tian[SUP] 6 [/SUP], Jing Xie[SUP] 2 [/SUP], Siyuan Fan[SUP] 7 [/SUP], Binbin Li[SUP] 8 [/SUP], Yingchun Xu[SUP] 1 [/SUP], Yongzhe Li[SUP] 1 [/SUP], Shuyang Zhang[SUP] 6 [/SUP]
Affiliations
- PMID: 33708903
- PMCID: PMC7944265
- DOI: 10.21037/atm-20-4877
Abstract
Background: Many studies have revealed several risk factors associated with the prognosis of patients with coronavirus disease 2019 (COVID-19), but the risk factors associated with death in critically ill COVID-19 patients still needs to be fully elucidated. Therefore, we analyzed clinical characteristics and laboratory data of ICU patients to identify risk factors associated with COVID-19 death.
Methods: Patients with COVID-19 from the ICU in the Sino-French New City Branch of Tongji Hospital Wuhan, China, between February 4 and February 29, 2020, were enrolled in this study. The final date of follow-up was April 4, 2020. Clinical manifestations, laboratory tests, treatment, and outcome of participants before and during the ICU stay were retrospectively collected and analyzed.
Results: A total of 92 patients were admitted or transferred to the ICU from February 4 to February 29, 2020. Compared to survivors, the majority of non-survivors (73.8%) presented with dyspnea. A random forest classifier and ROC curve were used to develop a predictive model. IL-6, D-dimer, lymphocytes, and albumin achieved good performance with AUCs of 0.9476, 0.9165, 0.8994, and 0.9251, respectively, which were consistent with clinical observations, such as inflammation, lymphopenia, and coagulation dysfunction. Combining IL-6 and D-dimer improved the performance of this model with an excellent AUC (0.997).
Conclusions: Mortality in COVID-19 was not rare in critically ill patients. The model that combined IL-6 and D-dimer was valuable for predicting the mortality of patients with COVID-19 with excellent performance. This model needs to be further optimized by adding more indicators and then evaluated with a multicenter study.
Keywords: Coronavirus disease 2019 (COVID-19); biomarkers; mortality; predictive model; risk factors.