Risk factors associated with mortality in patients hospitalized for coronavirus disease 2019 in Rio de Janeiro, Brazil

school Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil. school Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

0000-0001-5025-4007

Corresponding author: Prof. Dr. Paulo Vieira Damasco.
e-mail:paulovieiradamasco@gmail.com

*

These authors contributed equally to this work

Authors’ contribution: JCDC and VEFS: designed the study and wrote the manuscript; PVD: implemented the study; JCDC, VEFS, PHD and MLM: collected the data; JCDC and VEFS: performed the statistical analysis. All authors contributed to and approved the final manuscript.

Conflict of Interest: The authors declare no conflict of interest.

	Total		Survived		Died		p
	n	%	n	%	n	%
Age* (years)	71 (56, 86)		68 (53, 80)		75 (63, 88)		0.039
Sex
Male	50	51.0	25	46.3	25	56.8	0.300
Female	48	49.0	29	53.7	19	43.2
Comorbidity	89	90.8	47	87.0	42	95.5	0.180
Hypertension	71	72.4	38	70.4	33	75.0	0.610
Diabetes mellitus	29	29.6	14	25.9	15	34.1	0.378
Obesity	21	21.4	8	14.8	13	29.5	0.077
Stroke	19	19.4	6	11.1	13	29.5	0.022
Hypothyroidism	15	15.3	7	13.0	8	18.2	0.475
COPD	10	10.2	7	13.0	3	6.8	0.504
Atrial fibrillation	10	10.2	5	9.3	5	11.4	0.750
Congestive heart failure	10	10.2	4	7.4	6	13.6	0.337
Chronic kidney disease	10	10.2	5	9.3	5	11.4	0.750
Cancer	10	10.2	6	11.1	4	9.1	1.000
Immunosuppression	7	7.1	3	5.6	4	9.1	0.697
Coronary artery disease	7	7.1	2	3.7	5	11.4	0.238
Dyslipidemia	3	3.1	0	0.0	3	6.8	0.087
Asthma	3	3.1	2	3.7	1	2.3	1.000
Dementia	2	2.0	1	1.9	1	2.3	1.000
Myocardial infarction	1	1.0	0	0.0	1	2.3	0.449
HIV infection	1	1.0	0	0.0	1	2.3	0.449
Charlson Comorbidity Index**	3.6 ± 2.1		3.2 ± 2.3		4.2 ± 1.8		0.018
Prior hospitalization in the last 3 months	21	21.4	12	22.2	9	20.5	0.832
Nursing home resident	20	20.4	8	14.8	12	27.3	0.128
Prior pneumonia episode	4	4.1	1	1.9	3	6.8	0.323

	Total		Survived		Died		p
	n	%	n	%	n	%
Clinical characteristics
Cough	79	80.6	46	85.2	33	75.0	0.205
Dyspnea	75	76.5	42	77.8	33	75.0	0.747
Fatigue	50	51.0	25	46.3	25	56.8	0.300
Myalgia	39	39.8	20	37.0	19	43.2	0.536
Coryza	13	13.3	7	13.0	6	13.6	0.922
Pharyngitis	11	11.2	7	13.0	4	9.1	0.750
Diarrhea	7	7.1	5	9.3	2	4.5	0.454
Temperature* (°C)	36.7	(36.5, 37.4)	36.7	(36.5, 37.2)	37	(36.6, 37.7)	0.157
Heart rate*	82	(72, 93)	81	(72, 92)	84	(71, 96)	0.471
Respiratory rate*	22	(18, 24)	22	(18, 24)	22	(19, 24)	0.320
APACHE II score*	6	(6, 8)	6	(6, 8)	8	(6, 12)	0.001
SOFA score*	1	(1, 2)	1	(1, 2)	2	(1, 3)	<0.001
Glasgow coma scale*	15	(11, 15)	15	(14, 15)	12	(9, 15)	<0.001
Mean arterial pressure*	78	(75, 90)	79	(75, 92)	75	(69, 90)	0.028
<70 mm Hg	13	13.3	2	3.7	11	25.0	0.002
Oxygen saturation*	96	(92, 98)	96	(94, 98)	93	(90, 97)	0.002
<95%	41	41.8	16	29.6	25	56.8	0.007
Laboratory parameters
Hemoglobin** (mg/dL)	11.6 ± 2.0		11.8 ± 2.1		11.3 ± 2.0		0.236
Hematocrit** (%)	34.1 ± 6.2		34.5 ± 6.5		33.7 ± 5.8		0.532
Leucocytes* (x mm³)	7,900	(5,375, 11,900)	6,550	(5,100, 8,900)	10,750	(7,100, 15,100)	<0.001
Neutrophils* (x mm³)	6,300	(4,158, 9,520)	4898	(3,680, 7,144)	8,970	(5,822, 11,830)	<0.001
Lymphocytes* (x mm³)	1,188	(846, 1,775)	1,287	(945, 1,768)	987	(779, 1,860)	0.271
Monocytes* (x mm³)	420	(270, 564)	389	(264, 505)	445	(348, 650)	0.112
Platelets* (x 10³/mm³)	224	(157, 301)	220	(157, 279)	238	(157, 354)	0.292
NLR	5.3	(3.3, 8.2)	3.8	(2.6, 6.6)	6.6	(4.9, 11)	<0.001
MLR	0.3	(0.3, 0.5)	0.3	(0.2, 0.4)	0.4	(0.3, 0.6)	0.027
PLR	179.1	(121.7, 253)	169.8	(129, 230.3)	208.2	(107.3, 287.6)	0.130
Glucose* (mg/dL)	125	(115, 140)	120	(110, 135)	125	(115, 145)	0.056
BUN* (mg/dL)	48	(31, 94)	45	(30, 62)	76	(35, 145)	0.025
Creatinine* (mg/dL)	1.1	(0.7-1.9)	1.1	(0.7-1.5)	1.3	(0.7-2.8)	0.079
LDH* (U/L)	838	(548, 1,050)	620	(455, 1,007)	960	(604, 1,161)	0.017
Albumin** (g/dL)	2.8 ± 0.5		3.0 ± 0.5		2.6 ± 0.5		0.001
Total bilirubin* (mg/dL)	0.5	(0.3-0.7)	0.4	(0.3-0.6)	0.6	(0.4-1.0)	0.001
AST* (U/L)	61	(35-102)	55	(28-75)	70	(47-111)	0.029
ALT* (U/L)	47	(25-79)	35	(21-86)	54	(33-77)	0.301
C-reactive protein* (mg/L)	9	(5.4, 18.5)	7.8	(3.7, 11.5)	16.8	(6.9, 26.6)	0.001

	Mortality rate per 1000 patient-days (95% CI)		HR (95% CI)		p
Age
≤70 years	33.5	(17.4-64.3)
70 years	45.3	(31.1-66.1)	1.462	(0.786-2.718)	0.220
Stroke
No	36.7	(25.6-52.5)
Yes	42.1	(24.4-72.5)	1.278	(0.658-2.484)	0.461
Charlson Comorbidity Index
0-3	29.4	(17.4-49.6)
≥4	44.6	(31.0-64.2)	1.426	(0.751-2.708)	0.267
APACHE II score
0-6	27.1	(17.3-42.5)
≥7	56.3	(37.8-84.1)	1.995	(1.077-3.696)	0.023
SOFA score
0-1	22.0	(13.0-37.2)
≥2	59.1	(41.0-85.0)	2.602	(1.348-5.022)	0.003
Glasgow Coma scale
15	29.3	(18.2-47.1)
<15	47.6	(32.4-69.9)	1.645	(0.884-3.063)	0.107
Mean arterial pressure
≥70 mm Hg	31.6	(22.4-44.7)
<70 mm Hg	95.7	(53.0-172.7)	2.948	(1.469-5.916)	0.001
Oxygen saturation (%)
100%-95%	26.3	(16.8-41.3)
<95%	59.3	(39.7-88.4)	2.206	(1.192-4.083)	0.009
NLR
≤5	26.5	(15.4-45.6)
>5	47.2	(33.0-67.5)	2.064	(1.067-3.994)	0.025
Lactate dehydrogenase (U/L)
≤840	28.3	(16.4-48.7)
>840	45.0	(31.4-64.3)	1.655	(0.855-3.205)	0.124
Albumin (g/dL)
≥3	29.3	(18.9-45.5)
<3	50.8	(34.3-77.8)	1.649	(0.904-3.007)	0.094
Total bilirubin (mg/dL)
≤0.5	26.7	(16.6-43.0)
>0.5	53.0	(36.1-77.8)	2.263	(1.216-4.211)	0.007
AST (U/L)
≤50	32.7	(20.0-53.3)
>50	42.4	(29.1-61.8)	1.284	(0.689-2.392)	0.423
C-reactive protein (mg/L)
≤9	26.1	(15.8-43.3)
>9	50.6	(35.0-73.3)	1.991	(1.056-3.754)	0.027

	Total		Survived		Died		p
	n=98		n=54		n=44
Treatment
# Antibiotics*	2	(2-3)	2	(2-3)	3	(2-4)	0.106
Hydroxychloroquine (n, %)	43	44%	19	35%	24	55%	0.065
Macrolides (n, %)	86	88%	48	89%	38	86%	0.704
Ivermectin (n, %)	21	21%	10	19%	11	25%	0.437
Corticosteroids (n, %)	12	12%	5	9%	7	16%	0.330
LMWH (n, %)	94	96%	51	94%	43	98%	0.625
Blood transfusion (n, %)	9	9%	2	4%	7	16%	0.074
Hemodialysis	37	38%	4	7%	33	75%	0.561
Mechanical ventilation	44	45%	3	6%	41	93%	<0.001
Evolution
Length of stay*	9	(4-15)	10	(5, 17)	7	(4, 14)	0.220
Sepsis (n, %)	44	45%	1	2%	43	98%	<0.001
Septic shock (n, %)	43	44%	0	0%	43	98%	<0.001
ARDS	42	43%	2	4%	40	91%	<0.001
Acute renal failure (n, %)	50	51%	13	24%	37	84%	<0.001
Acute liver failure (n, %)	29	30%	6	11%	23	52%	<0.001
DIC	16	16%	0	0%	16	36%	<0.001
Encephalitis (n, %)	12	12%	0	0%	12	27%	<0.001

[TFN1] (*) median (IQR); (**) mean ± standard deviation (SD); COPD: chronic obstructive pulmonary disease; HIV: human immunodeficiency.