Risk Factors Related to the Death of Admitted COVID-19 Patients: A Buffalo Study.

Background: Coronavirus disease 2019 (COVID-19) may result in a severe acute respiratory syndrome that leads to a worldwide pandemic. Despite the increasing understanding of COVID-19 disease, the mortality rate of hospitalized COVID-19 patients remains high.

Objective: To investigate the risk factors related to the mortality of admitted COVID-19 patients during the peak of the epidemic from August 2021 to October 2021 in Vietnam.

Methods: This is a prospective cohort study performed at the Hospital for Rehabilitation-Professional diseases. The baseline and demographic data, medical history, clinical examination, the laboratory results were recorded for patients admitted to the hospital with confirmed COVID-19. A radiologist and a pulmonologist will read the chest radiographs on admission and calculate the Brixia scores to classify the severity of lung abnormalities. Patients were followed up until beingrecovered or their death. Comparison of clinical and subclinical characteristics between recovery and death groups to find out risk factors related to the death of COVID-19 patients.

Results: Among 104 admitted COVID-19 patients, men accounted for 42.3%, average age of 61.7 ± 13.7. The most common symptoms were fever 76.9%, breathlessness 74%, and fatigue 53.8%. The majority (84.6%) of the study population had at least one co-morbidity, including hypertension (53.8%), diabetes (25.9%), gastritis (19.2%), ischemic heart disease (15.4) %), stroke (9.6%) and osteoarthritis (9.6%). The rate of mild and moderate COVID-19 is 13.4%, severe 32.7%, and critical 40.4%. There are 88 inpatients (84.6%) who needed respiratory support. The median hospital stay was 13 days (IQR 10-17.75 days). The rate of intubated patients with mechanical ventilation was 31.7%. The overall mortality rate was 29.8%. Risk factors related to death included Brixia scores > 9, Urea > 7 mmol/L, Ferrtin > 578 ng/ml, Failure to get vaccinated, Age > 60 years, and Low Oxygen SpO2 < 87% (BUFFALO).

Conclusion: The main result of the study is the independent risk factors related to the death of admitted COVID-19 patients including Brixia scores > 9, Urea > 7 mmol/L, Ferrtin > 578 ng/ml, Failure to get vaccinated, Age > 60 years, and Low Oxygen SpO2 < 87% ((BUFFALO) which suggests that these COVID-19 patients should be closely followed up.