Abstract:

Objective: Cytokine storm and macrophage activation were shown to be important factors in the pathogenesis of SARS-CoV-2 infection. We aimed to investigate the factors associated with mortality in patients with COVID-19 infection. Material and Method:We grouped the adult patients followed-up with COVID-19 infection: Group A,outpatient (mild symptoms of COVID-19 infec-tion, but no CT findings); Group B,mild/moderate illness (fever and respiratory tract symptoms of COVID-19 infection together with pneumonia on CT); Group C,severe (respiratory rate >30/minute, or oxygen saturation at room air of <93%, or PaO2/FiO2 of <300, or increase in CT findings more than 50% in 1-2 days) or critical illness (shock, or respiratory insufficiency requiring mechanical ventilation, or organ failure necessitating intensive care). Results: Of total (n =166), 38.6%(n =64) were female. Mean age was 57.69(±9.8). Group A comprises of 22.9% (n =38), Group B 59.0% (n =98), and Group C 18.1% (n =30) of the patients. 8.4% of the patients (n =14) were died. ROC analysis revealed that age (>61-year), CRP (>62 mg/dL), ferritin (>385 ng/mL), D-dimer (>0.8 ng/mL), lymphocyte (≤850/mm3), procalcitonin (>0.08 μg/L), fibrinogen (>538 mg/dL), LDH (>469 U/L), AST (>39 U/L), SaO2 (≤87%), and duration of hospitalization (>7 days) predicted the mortality. Kaplan-Meier analysis also showed that age (>61 year), smoking (present), SaO2, procalcitonin (>0.08 μg/L), LDH (>469 U/L) were associated with mortality. Cox regression analysis revealed that age (>61), CRP (>62), and LDH (>469) were positive predictors for mortality. Conclusion: We made an extensive analysis in a small patient population with a diagnosis of COVID-19 infection, and found a high rate of mortality. Older age, inflammatory biomarkers, mainly CRP and LDH, were associated with the mortality.

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