Background To date, survival data on risk factors for COVID-19 mortality in western Europe is limited, and none of the published survival studies have used a competing risk approach. This study aims to identify risk factors for in-hospital mortality in COVID-19 patients in the Netherlands, considering recovery as a competing risk. Methods In this observational multicenter cohort study we included adults with PCR-confirmed SARS-CoV-2 infection that were admitted to one of five hospitals in the Netherlands (March to May 2020). We performed a competing risk survival analysis, presenting cause-specific hazard ratios (HR CS ) for the effect of preselected factors on the absolute risk of death and recovery. Results 1,006 patients were included (63.9% male; median age 69 years, IQR: 58–77). Patients were hospitalized for a median duration of 6 days (IQR: 3–13); 243 (24.6%) of them died, 689 (69.9%) recovered, and 74 (7.4%) were censored. Patients with higher age (HR CS 1.10, 95% CI 1.08–1.12), immunocompromised state (HR CS 1.46, 95% CI 1.08–1.98), who used anticoagulants or antiplatelet medication (HR CS 1.38, 95% CI 1.01–1.88), with higher modified early warning score (MEWS) (HR CS 1.09, 95% CI 1.01–1.18), and higher blood LDH at time of admission (HR CS 6.68, 95% CI 1.95–22.8) had increased risk of death, whereas fever (HR CS 0.70, 95% CI 0.52–0.95) decreased risk of death. We found no increased mortality risk in male patients, high BMI or diabetes. Conclusion Our competing risk survival analysis confirms specific risk factors for COVID-19 mortality in a the Netherlands, which can be used for prediction research, more intense in-hospital monitoring or prioritizing particular patients for new treatments or vaccination.
【초록키워드】 Treatment, Europe, vaccination, Hospitalized, SARS-COV-2 infection, hospital, LDH, risk, diabetes, risk factor, survival, Fever, male, Research, Patient, death, Immunocompromised, age, BMI, medication, Admission, patients, in-hospital mortality, Blood, Early warning score, Anticoagulant, Analysis, antiplatelet, COVID-19 mortality, COVID-19 patient, Netherlands, In-hospital, risk of death, Factor, 95% CI, PCR-confirmed, increased risk, hazard ratio, median age, increased mortality, approach, FIVE, multicenter cohort study, Result, identify, performed, died, median, Netherland, can be used, presenting, competing, 【제목키워드】 risk, survival, in-hospital mortality, Analysis, COVID-19 patient, Factor, laboratory-confirmed, competing,