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Risk Factors Linked to In-Hospital Death in COVID-19 Identified

Older age, higher score for organ failure, d-dimer >1 µg/mL linked to increased odds of in-hospital death

doctor examining his patient wearing oxygen mask

THURSDAY, March 12, 2020 (HealthDay News) -- Older age, higher Sequential Organ Failure Assessment score, and d-dimer are associated with increased odds of in-hospital death among patients with novel coronavirus 2019 (COVID-19), according to a study published online March 11 in The Lancet.

Fei Zhou, M.D., from Peking Union Medical College in Beijing, and colleagues conducted a retrospective study involving all 191 adult inpatients from two hospitals in Wuhan with laboratory-confirmed COVID-19 who had been discharged or had died by Jan. 31, 2020 (137 discharged and 54 died in hospital). Demographic, clinical, treatment, and laboratory data were extracted and compared for survivors and nonsurvivors. The authors explored the risk factors associated with in-hospital death.

The researchers found that 91 patients had a comorbidity, most commonly hypertension, diabetes, and coronary heart disease (58, 36, and 15 patients, respectively). In multivariable analyses, the odds of in-hospital death were increased in association with older age (odds ratio, 1.10 per year increase), higher Sequential Organ Failure Assessment score (odds ratio, 5.65), and d-dimer greater than 1 µg/mL (odds ratio, 18.42) on admission. In survivors, the median duration of viral shedding was 20.0 days; in nonsurvivors, SARS-CoV-2 was detectable until death. In survivors, the longest observed duration of viral shedding was 37 days.

"The prolonged viral shedding provides the rationale for testing novel coronavirus antiviral interventions in efforts to improve outcomes," the authors write.

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