Abstract
Background: Determination of the prognostic factors which affects the
mortality and morbidity in COVID-19 patients, has an importance in terms
of planning the treatment and follow-up strategy. Material and Method:
Patients who had COVID-19 diagnosis via microbiologically and/or
radiologically between March and October 2020 in a tertiary-care
university hospital were recorded retrospectively. Only adult patients
(≥18 years) with clinical spectrum of moderate, severe and critical
illness were included in the study according to National Institutes of
Health (NIH) guideline. A p value of less than 0.05 was considered
significant. Ethical committee approval was given from the Uludag
University with decision number 2020-22/11. Also, the permission from
Republic of Turkey, Ministry of Health was given. Results: A total
number of 257 patients were included in the study. 30-day mortality rate
was recorded as 14.4%. In univariate analysis; age, chronic renal
failure, malignancy, cerebrovascular disease, number of comorbidities
>2, dyspnea, cough, NIH severe and critical illness, oxygen
saturation, respiratory rate, systolic and diastolic blood pressure,
qSOFA, GCS, MEWS, SOFA, CURB-65, CCI, CRP, procalcitonin, CK, D-dimer,
lymphocyte and thrombocyte levels, neutrophile-to-lymphocyte ratio, AST,
albumin, hemoglobin, CK-MB, fibrinogen, LDH and potassium levels were
found as statistically significant (p<0.05). In logistic
regression analysis one point increase of SOFA (p<0.001,
OR:1.861, 95%CI:1.403-2.468) and CURB-65 scores (p=0.002, OR:2.484,
95%CI:1.401-4.406) were found as statistically significant for 30-day
mortality. In mortal patients, there were significant difference between
the baseline, day 3, 7 and 14 results of D-dimer (p=0.01), Ferritin
(p=0.042), leucocyte (p=0.019) and neutrophile count (p=0.007).
Conclusion: In our study, SOFA and CURB-65 scores on admission were
associated with mortality and these score systems might be useful tools
for the prognosis in COVID-19 patients.In addition to this, D-dimer,
Ferritin, leucocyte and neutrophile counts were significantly increased
during the follow up in patients with mortality.