ANALYSIS OF FATAL CASES IN CORONAVIRUS INFECTION COVID-19
Introduction. An important characteristic of an infectious disease, especially caused by a new pathogen such as SARS-CoV-2, is its severity, the ultimate measure of which is its ability to cause death. Mortality rates help us understand the severity of the disease, identify risk groups, and assess the quality of medical care.
Objective. To study the risk factors for the development of an unfavorable outcome in patients with COVID-19-associated pneumonia.
Material and methods. A retrospective analysis was conducted of 292 medical records of inpatient patients with COVID-19-associated pneumonia (251 patients (86%) with confirmed cases and 41 patients (14%) with probable cases of COVID-19) who had a fatal outcome. The study was conducted based on the stories of deceased patients who were on inpatient treatment at the GCP at the City Infectious Diseases Center of Astana in the period from 2021 to 2022.
The statistical processing of the obtained data was carried out using methods of descriptive statistics. Quantitative data were described using the median (Me) and lower and upper quartiles (Q1 – Q3), categorical data were described with absolute values and percentages using IBMSPSS Statistics 20.0 and Jamovi.
Results and discussion. The conducted studies have shown that the fatal outcome in patients with COVID-19-associated pneumonia is more often registered in older age groups (mainly in people over 65 years of age). Predictors of an unfavorable outcome of the disease are late hospitalization (38.6% of patients were hospitalized for 7-9 days of illness, 21.4% of patients were hospitalized for 10 days or more), the severity of the condition during hospitalization (severe course was registered in 66.7% of patients, extremely severe – in 33.3% of patients), associated with the presence of complications already at the time of hospitalization against the background of severe concomitant diseases. The lack of vaccination status for COVID-19 could also affect the possibility of the development and severity of the course of the COVID-19 coronavirus infection. The main causes of death in COVID-19 are respiratory failure, pulmonary embolism, sepsis, and acute respiratory distress syndrome. Concomitant diseases such as hypertension, chronic heart failure, cardiac arrhythmia, obesity, and type 2 diabetes mellitus aggravate the course of COVID-19 infection.
Laboratory predictors of an unfavorable outcome are lymphopenia, increased erythrocyte sedimentation rate (ESR), the content of C-reactive protein (CRP), interleukin-6 (IL-6), D-dimers and procalcitonin (PCT). The severity of these changes correlated directly with the severity of the disease.
Conclusions: Risk factors for an unfavorable outcome of COVID-19-associated pneumonia are old age, late hospitalization, severity of the condition, and the presence of complications at the time of admission of patients to the hospital against the background of severe concomitant pathology. The severity of the condition and the risk of death were associated with the severity of lymphopenia, the degree of increase in ESR, the content of CRP, IL-6, D-dimers and procalcitonin.
Identification and consideration of the above-mentioned risk factors for the development of a fatal outcome will make it possible to predict the possibility of an unfavorable course of the disease in a timely manner and adjust the necessary therapeutic measures to prevent the occurrence of complications that may cause death.
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COVID-19 - Topical Subject
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Kulzhanova Sh.A., Sapar Zh.M., Turebaeva G.O. Analysis of fatal cases in coronavirus infection COVID-19 // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 5, pp. 7-16. doi 10.34689/SH.2023.25.5.001Related publications:
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