Acta clinica Croatica, Vol. 62. No. 1, 2023.
Original scientific paper
https://doi.org/10.20471/acc.2023.62.01.13
Factors Affecting Prognosis and Mortality in Severe COVID-19 Pneumonia Patients
Emine Afşin
orcid.org/0000-0002-2450-6378
; Abant Izzet Baysal University Hospital, Department of Chest Diseases, Bolu, Turkey
Muhammed Emin Demirkol
; Abant Izzet Baysal University Hospital, Department of İnternal Medicine, Bolu, Turkey
Abstract
Fatality rate in coronavirus disease 2019 (COVID-19) cases has been reported to be
3.4% worldwide. The aim of this study was to evaluate the factors that determine prognosis and mortality
in severe COVID-19 pneumonia patients. Eighty adult patients with severe COVID-19 pneumonia
hospitalized and monitored at Izzet Baysal State Hospital (Bolu, Turkey) between August and November
2020 were included in this retrospective single-center study. Demographic and laboratory data,
severity of radiological involvement, comorbidities, agents used in treatment, and clinical results were
recorded, and data were grouped as survivors and non-survivors. The mean patient age was 67.8±12.6
years. There were 59 (73.8%) male patients. Comorbid diseases were present in 53 (66.3%) patients.
There was no significant relationship between patient age, gender, smoking status or presence of comorbidity
and mortality (p>0.05). The variables such as pulmonary involvement above 50%, intubation, or
ferritin (>434.8 μg/L), troponin I (>14.05 ng/L) and procalcitonin (>0.125 ng/mL) as the sole variables
of laboratory data were found to have significant relationship with increased mortality (p<0.05). Mortality
was significantly higher in patients using steroid pulse therapy + tocilizumab, steroid pulse therapy +
hydroxychloroquine, or solely steroid pulse therapy, while it was significantly lower in patients receiving
azithromycin therapy and those in the plasma + steroid pulse therapy group. The severity of pulmonary
involvement, intubation, and increase in inflammation markers such as ferritin, troponin and procalcitonin
were found to be significantly associated with mortality (p<0.05). Treatment approaches with
azithromycin and plasma + steroid pulse therapy were found to reduce mortality.
Keywords
COVID-19; Pneumonia; Prognosis; Mortality
Hrčak ID:
307172
URI
Publication date:
1.4.2023.
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