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J Med Virol . Multiple Organ Injury on Admission Predicts In-Hospital Mortality in Patients with COVID -19

tetano

Editor, Senior Moderator
J Med Virol


. 2020 Sep 19.
doi: 10.1002/jmv.26534. Online ahead of print.
Multiple Organ Injury on Admission Predicts In-Hospital Mortality in Patients with COVID -19


He Yan[SUP] 1 [/SUP], Shanshan Lu[SUP] 2 [/SUP], Liangpei Chen[SUP] 1 [/SUP], Yufang Wang[SUP] 1 [/SUP], Qiaomei Liu[SUP] 3 [/SUP], Dongsheng Li[SUP] 4 [/SUP], Xisheng Yan[SUP] 4 [/SUP], Jie Yan[SUP] 1 [/SUP]



Affiliations

Abstract

Background: Multiorgan injury has been implicated in patients with coronavirus disease 2019 (COVID-19). We aim to assess the impact of organ injury (OI) on prognosis according to the number of affected organs at admission.
Methods: This is a retrospective cohort study of patients with confirmed COVID-19 in Wuhan Third Hospital & Tongren Hospital of Wuhan University from February 17 to March 22, 2020. We classified the patients according to the presence and number of damaged organs (heart, liver, and kidney).
Results: The percentage of patients with no, one, two, or three organs affected was 59.75%, 30.46%, 8.07%, and 1.72%, respectively. With the increasing number of OI, there is a tendency of gradual increase regarding the white blood cell counts, neutrophil counts, levels of C-reactive protein, lactate dehydrogenase, D-dimer, and fibrinogen as well as the incidence of most complications. In a Cox regression model, individuals with OI, old age, and an abnormal level of C-reactive protein were at a higher risk of death compared with those without. Patients with three organ injuries had the highest mortality rate [57.9%; hazard ratio (HR) with 95% confidence interval (CI) vs. patients without OI: 22.31 (10.42-47.77), those with two (23.6%; HR 8.68, 95% CI 4.58-16.48), one (8.6%; HR 3.1, 95% CI 1.7-5.7), or no OI (2.6%); P < 0.001].
Conclusion: The increasing number of OI was associated with a high risk of mortality in COVID-19 infection. This article is protected by copyright. All rights reserved.

Keywords: COVID-19; Mortality; Organ Injury; Risk Factor; SARS-CoV-2.
 
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