Abstract
Background During COVID-19 outbreak, Italy was the first country in Europe to be heavily affected with an intensive care unit mortality of 26%. In order to reduce this percentage, physicians should establish clear and objective criteria to stratify COVID-19 patients at high risk of in-hospital death. Thus, the aim has been to test a large spectrum of variables ranging from clinical evaluation to laboratory biomarkers to identify which parameter would best predict all-cause in-hospital mortality in COVID-19 patients. Design observational study. Results Multivariate Cox regression analysis showed that each 5 years of increase in age corresponded to a hazard ratio (HR) of 1.28 (95% CI 1.00-1.65, P = .050); each increment of 803 ng/L of N-terminal pro-B-type natriuretic peptide (NT-proBNP) corresponded to a HR of 1.24 (95% CI 1.11-1.39, P < .001); each increment of 58 ng/L of interleukin (IL)-6 corresponded to a HR of 1.23 (95% CI 1.09-1.40, P < .001), and each increment of 250 U/L of lactate dehydrogenase (LDH) corresponded to a HR of 1.23 (95% CI 1.10-1.37, P < .001). According to the calculated cut-points for age (≥70 years), NT-proBNP (≥803 ng/L), IL-6 (≥58 ng/L) and LDH (≥371 U/L) when 2 out of these 4 were overcome, the HR was 2.96 (95% CI 1.97-4.45, P < .001). Conclusion In COVID-19 patients, besides age, the evaluation of three biochemical parameters, available in few hours after hospital admission can predict in-hospital mortality regardless of other comorbidities.
Keywords: COVID-19; NT-proBNP; PCSK9; Tn-T; in-hospital mortality; interleukin 6; lactate dehydrogenase.
【저자키워드】 COVID-19, lactate dehydrogenase, interleukin 6, NT-proBNP, in-hospital mortality, PCSK9, Tn-T, 【초록키워드】 Europe, Mortality, intensive care, IL-6, Comorbidities, peptide, LDH, Italy, lactate dehydrogenase, observational study, interleukin 6, Hospital mortality, interleukin, COVID-19 outbreak, clinical evaluation, age, Hospital admission, laboratory biomarkers, NT-proBNP, predict, in-hospital mortality, COVID-19 patients, Lactate, PCSK9, COVID-19 patient, criteria, high risk, In-hospital death, In-hospital, Biochemical parameters, 95% CI, hazard ratio, Cox regression analysis, multivariate, physician, N-terminal pro-B-type natriuretic peptide, multivariate Cox regression analysis, parameter, N-terminal, variable, country, Result, identify, affected, calculated, overcome, increase in, reduce, laboratory biomarker, pro-B-type natriuretic peptide, 【제목키워드】 in-hospital mortality, parameter, Italian,