Clinical Predictors of In-Hospital Outcomes in COVID-19 Patients: A Retrospective Cohort Study

Abstract

Background: We do not have detailed evidence on conditions or treatments that act as predictors of hospital outcomes. Objective: To identify the clinical predictors of hospital outcomes in COVID-19 patients and to evaluate the effect of therapeutic’s interventions on length of stay, ICU admission, need for mechanical ventilation (MV) and mortality. Materials and methods: The primary outcome was to assess whether any treatment alone or in combination with standard care, was able to reduce ICU admission, need for MV or mortality. The secondary end points were 1) To know if any single or combined treatment was able to reduce the length of stay in the hospital, MV and ICU, 2) Whether some form of oxygen support prevented MV and 3) Which clinical predictors are relevant for worse outcome. Results: AZM-Corticosteroid and therapeutic anticoagulation when indicated reduced the ICU stay in 1.5 day and MV in 4 days, but when the same combination included HCQ this time increased. For the AZM-Corticosteroid and therapeutic anticoagulation combination the mean ICU length stay was 15.9 days, however when HCQ was present, again the mean ICU time was 40.3 days. The clinical predictors at admission for death were: Age > 65 years, presence of up one comorbidity, pulmonary involvement more than 50%, saturation < 93%, lymphocytes < 900 mm3, D-dimers > 1.250 ng/mL and C-reactive protein (CRP) > 8.0 mg/dL. Conclusion: AZM-Corticosteroids and therapeutic anticoagulation, when indicated, represented a favorable combination for inpatients with COVID-19.Some clinical predictors at admission may help to estimate a higher risk of poor evolution.