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Predictors of Mortality in Hospitalized Patients with COVID-19-Related Illness

Rationale Predictive models of mortality for COVID 19 related illness have yet to be sufficiently tested. We analyzed the data of confirmed COVID-19 cases to determine possible predictors of mortality in hospitalized patients with COVID-19 related illness. Consideration was given to demographic information, pre-existing patient conditions and acute management. Methods We collected data from a convenience sampling of patients who received care at a multicenter healthcare system in southern California between March and August 2020. Data from this retrospective review of the electronic health record included demographics (age, gender, BMI and ethnicity), comorbidities (HTN, DM, CHF, chronic lung disease), lab values, certain medications (statins, antihypertensives, experimental therapies) and mortality risk by way of the updated Charlson Comorbidity index (CCI), which includes 12 categories of comorbidity predicting 1-year mortality (Quan et al., 2011). Cases were grouped as expired vs. survived. Chi square (categorical) and t-tests (continuous) were performed to determine statistical significance and Pearson r (categorical) and eta (continuous) were performed to test strength of association. Logistic regression was performed to test a predictability model for variables with the highest degree of statistical significance and correlation with mortality. Results Of 5,559 cases reviewed, 139 cases had complete data available for analysis. Of the total sample, mean age was 61(+/-16.1) and 38.8% female. Thirtyseven (26.6%) patients expired and 102 (73.4%) patients survived. Four variables were found to have a statistically significant, yet mild association with mortality. These four variables included: Betablocker use (p = 0.028, r = 0.186), CHF (p = 0.018, r = 0.200), chronic lung disease (p = 0.011, r = 0.217) and CCI (p 0.03, r = 0.216). Two variables had statistically significant and strong correlations to mortality;Age (p = 0.004, r = 0.636) and CRP (p = 0.003, r = 0.937). CRP and age accounted for 73.4% predictive value of mortality in our model. Conclusions Our analysis contributes further understanding of predictors of mortality in hospitalized patients with a confirmed diagnosis of COVID-19. HTN and DM were not associated with increased risk of mortality. Use of beta blockers, CHF and chronic lung disease had mild degree of association with mortality. Age and CRP served as strong predictors of mortality in our model. This retrospective convenience sample study was not conducted by way of a powered investigation. Findings should be confirmed by way of a well powered investigation before inferring utility of the model.