1Department of Pulmonology and Critical Care Medicine, Chosun University Hospital, Gwangju, Korea
2Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
3Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
4Division of Allergy and Pulmonology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
5Division of Allergy and Respiratory Diseases, Soonchunhyang University Hospital, Seoul, Korea
6Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea
7Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Daejeon, Korea
Copyright © 2022 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conceptualization: YSN, JHK, SIL. Data curation: all authors. Formal analysis: SIL. Methodology: SIL. Visualization: YSN, JHK, SIL. Writing–original draft: all authors. Writing–review & editing: all authors.
Values are presented as median (interquartile range) or number (%).
COVID-19: coronavirus disease 2019; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; RR: respiratory rate; SpO2: saturation pulse oxygen; GCS: Glasgow coma scale; BUN: blood urea nitrogen.
Values are presented as median (interquartile range).
COVID-19: coronavirus disease 2019; APACHE: Acute Physiology and Chronic Health Evaluation, SOFA: Sequential Organ Failure Assessment, CURB-65: confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older, MEWS: Modified Early Warning.
OR: odds ratio; CI: confidence interval; APACHE: Acute Physiology and Chronic Health Evaluation; SOFA: Sequential Organ Failure Assessment; CURB-65: confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older; MEWS: modified early warning score; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease.
Variable | All patients (n=318) | Survivor (n=237) | Non-survivor (n=81) | P-value |
---|---|---|---|---|
Age (yr) | 78 (71–84) | 76 (69–84) | 80 (75–85) | 0.001 |
Male | 136 (42.8) | 96 (40.5) | 40 (49.4) | 0.163 |
Smoking | 57 (17.9) | 44 (18.6) | 13 (16.0) | 0.610 |
Symptom at admission | 244 (76.7) | 181 (76.4) | 63 (77.8) | 0.796 |
Symptom to admission (day) | 3.0 (1.0–7.0) | 4.0 (1.0–8.0) | 2.0 (0.8–6.0) | 0.451 |
Body mass index (kg/m2) | 23.1 (20.7–25.9) | 23.2 (20.8–25.9) | 22.8 (19.8–26.6) | 0.519 |
Resident of a nursing facilities | 76 (23.9) | 55 (23.2) | 21 (25.9) | 0.620 |
Comorbidity | ||||
Hypertension | 201 (63.2) | 144 (60.8) | 57 (70.4) | 0.122 |
DM | 116 (36.5) | 75 (31.6) | 41 (50.6) | 0.002 |
COPD | 12 (3.8) | 5 (2.1) | 7 (8.6) | 0.008 |
Cerebrovascular disease | 42 (13.2) | 30 (12.7) | 12 (14.8) | 0.621 |
Heart failure | 16 (5.0) | 13 (5.5) | 3 (3.7) | 0.527 |
Liver cirrhosis | 4 (1.3) | 2 (0.8) | 2 (2.5) | 0.257 |
Chronic kidney disease | 5 (1.6) | 4 (1.7) | 1 (1.2) | 0.777 |
Malignancy | 18 (5.7) | 15 (6.3) | 3 (3.7) | 0.377 |
Vital sign | ||||
SBP (mm Hg) | 121 (108–140) | 121 (109–140) | 120 (106–134) | 0.203 |
DBP (mm Hg) | 71 (61–81) | 72 (64–82) | 67 (53–79) | 0.002 |
HR (/min) | 86 (73–99) | 84 (73–97) | 90 (71–103) | 0.115 |
RR (/min) | 20 (19–24) | 20 (19–22) | 22 (20–26) | 0.003 |
Body temperature (℃) | 36.7 (36.4–37.4) | 36.8 (36.4–37.4) | 36.6 (36.4–37.2) | 0.092 |
SpO2 (%) | 95.0 (92.0–98.0) | 96.0 (93.0–98.0) | 95.0 (90.5–98.0) | 0.055 |
GCS | 15 (14–15) | 15 (15–15) | 15 (12–15) | <0.001 |
Duration of fever | 2.0 (0.0–4.3) | 2.0 (0.0–4.0) | 2.0 (0.0–6.5) | 0.124 |
Laboratory data | ||||
White blood cell (1,000/mm3) | 5.91 (4.36–7.98) | 5.54 (4.23–7.72) | 7.01 (4.95–9.22) | 0.007 |
Neutrophil lymphocyte ratio | 4.56 (2.75–9.60) | 4.04 (2.52–8.65) | 7.62 (4.01–15.60) | 0.002 |
Hemoglobin (g/dl) | 12.6 (11.2–13.8) | 12.8 (11.5–13.8) | 12.2 (10.6–13.5) | 0.013 |
Platelet count (1,000/mm3) | 179 (134–228) | 184 (145–234) | 154 (116–216) | 0.001 |
Total bilirubin (mg/dl) | 0.5 (0.3–0.7) | 0.5 (0.3–0.6) | 0.5 (0.3–0.7) | 0.087 |
Albumin (g/dl) | 3.5 (3.1–3.8) | 3.5 (3.2–3.9) | 3.2 (2.8–3.6) | <0.001 |
BUN (mg/dl) | 16 (12–24) | 16 (11–22) | 20 (13–35) | 0.001 |
Creatinine (mg/dl) | 0.78 (0.60–1.00) | 0.74 (0.58–0.94) | 0.82 (0.65–1.29) | 0.015 |
C-reactive protein (mg/dl) | 5.70 (2.07–10.58) | 4.74 (1.57–9.24) | 7.93 (3.80–15.67) | 0.002 |
Chest X-ray | ||||
Normal | 51 (16.0) | 44 (18.6) | 7 (8.6) | 0.036 |
Unilateral | 52 (16.4) | 39 (16.5) | 13 (16.0) | 0.932 |
Bilateral | 138 (43.4) | 100 (42.2) | 38 (46.9) | 0.459 |
Multifocal | 77 (24.2) | 54 (22.8) | 23 (28.4) | 0.309 |
Variable | All patients (n=318) | Survivor (n=237) | Non-survivor (n=81) | P-value |
---|---|---|---|---|
Treatment | ||||
Remdesivir | 168 (52.8) | 119 (50.2) | 49 (60.5) | 0.109 |
Antibiotics | 211 (66.4) | 148 (62.4) | 63 (77.8) | 0.012 |
Vasopressor | 48 (15.1) | 17 (7.2) | 31 (38.3) | <0.001 |
CRRT | 20 (6.3) | 4 (1.7) | 16 (19.8) | <0.001 |
Steroid | 244 (76.7) | 171 (72.2) | 73 (90.1) | 0.001 |
Oxygen supply device | ||||
Nasal prong | 257 (80.8) | 209 (88.2) | 48 (59.3) | <0.001 |
HFNC | 110 (34.6) | 62 (26.2) | 48 (59.3) | <0.001 |
Invasive mechanical ventilation | 80 (25.2) | 36 (15.2) | 44 (54.3) | <0.001 |
ECMO | 10 (3.1) | 3 (1.3) | 7 (8.6) | 0.001 |
Tracheostomy (%) | 27 (8.5) | 14 (5.9) | 13 (16.0) | 0.005 |
Outcome | ||||
Length of hospital stay (day) | 17.0 (12.0–26.0) | 17.0 (13.0–25.0) | 17.0 (10.0–27.0) | 0.748 |
Secondary infection | 103 (32.4) | 62 (26.2) | 41 (50.6) | <0.001 |
DNR order | 76 (23.9) | 17 (7.2) | 59 (72.8) | <0.001 |
Variable | All patients (n=318) | Survivor (n=237) | Non-survivor (n=81) | P-value |
---|---|---|---|---|
Frailty | ||||
Clinical frailty scale | 4.0 (3.0–7.0) | 3.0 (3.0–6.0) | 6.0 (4.0–7.0) | <0.001 |
Charlson comorbidity index | 4.0 (3.0–5.0) | 4.0 (3.0–5.0) | 5.0 (4.0–6.0) | <0.001 |
Severity score | ||||
APACHE II score | 11.5 (9.0–15.0) | 11.0 (8.0–14.0) | 14.0 (11.0–19.0) | <0.001 |
SOFA score | 2.0 (1.0–4.0) | 1.0 (0.0–3.0) | 4.0 (2.0–8.5) | <0.001 |
CURB-65 score | 2.0 (1.0–2.0) | 1.0 (1.0–2.0) | 2.0 (1.5–3.0) | <0.001 |
MEWS | 1.0 (1.0–2.0) | 1.0 (1.0–2.0) | 2.0 (1.0–3.0) | <0.001 |
Variable | Univariate analysis |
Multivariate analysis |
||
---|---|---|---|---|
OR (95% CI) | P-value | OR (95% CI) | P-value | |
Age | 1.040 (1.014–1.067) | 0.003 | 1.029 (0.999–1.059) | 0.054 |
Male | 1.106 (0.711–1.720) | 0.656 | ||
Frailty | ||||
Clinical frailty scale | 1.217 (1.094–1.355) | <0.001 | 1.274 (1.112–1.460) | <0.001 |
Charlson comorbidity index | 1.444 (1.245–1.675) | <0.001 | 1.103 (0.863–1.411) | 0.434 |
Severity score | ||||
APACHE II score | 1.070 (1.035–1.106) | <0.001 | 1.025 (0.972–1.081) | 0.364 |
SOFA score | 1.119 (1.066–1.175) | <0.001 | 1.144 (1.082–1.211) | <0.001 |
CURB-65 score | 1.608 (1.259–2.053) | <0.001 | 1.024 (0.727–1.441) | 0.894 |
MEWS | 1.144 (1.020–1.283) | 0.022 | 0.916 (0.799–1.050) | 0.207 |
Comorbidity (%) | ||||
DM | 1.686 (1.086–2.617) | 0.020 | 1.988 (1.240–3.188) | 0.001 |
COPD | 3.717 (1.695–8.154) | 0.001 | 2.462 (1.093–5.546) | 0.030 |
Cerebrovascular disease | 1.409 (0.760–2.613) | 0.277 | ||
Chronic kidney disease | 0.726 (0.101–5.232) | 0.751 | ||
Malignancy | 0.588 (0.185–1.866) | 0.367 | ||
Laboratory data | ||||
White cell count (1,000/mm3) | 1.055 (1.010–1.102) | 0.016 | 1.051 (1.003–1.101) | 0.038 |
Hemoglobin (g/dl) | 0.911 (0.824–1.007) | 0.068 | ||
Platelet count (1,000/mm3) | 0.996 (0.993–1.000) | 0.031 | 0.998 (0.995–1.002) | 0.378 |
Albumin (g/dl) | 0.443 (0.285–0.689) | <0.001 | 0.875 (0.517–1.481) | 0.619 |
Total bilirubin (mg/dl) | 1.549 (1.036–2.316) | 0.033 | 1.373 (0.894–2.108) | 0.148 |
Creatinine (mg/dl) | 1.150 (1.016–1.301) | 0.027 | 0.975 (0.821–1.159) | 0.778 |
C-reactive protein (mg/dl) | 1.109 (0.994–1.045) | 0.142 |
Values are presented as median (interquartile range) or number (%). COVID-19: coronavirus disease 2019; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; RR: respiratory rate; SpO2: saturation pulse oxygen; GCS: Glasgow coma scale; BUN: blood urea nitrogen.
Values are presented as number (%) or median (interquartile range). COVID-19: coronavirus disease 2019; CRRT: continuous renal replacement therapy; HFNC: high-flow nasal cannula; ECMO: extracorporeal membrane oxygenation; DNR: do-not-resuscitate.
Values are presented as median (interquartile range). COVID-19: coronavirus disease 2019; APACHE: Acute Physiology and Chronic Health Evaluation, SOFA: Sequential Organ Failure Assessment, CURB-65: confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older, MEWS: Modified Early Warning.
OR: odds ratio; CI: confidence interval; APACHE: Acute Physiology and Chronic Health Evaluation; SOFA: Sequential Organ Failure Assessment; CURB-65: confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older; MEWS: modified early warning score; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease.