PREDICTORS OF DISEASE SEVERITY IN COVID-19 PATIENTS

Milivoje  Djurić; Mirjana  Makević Djurić; Ivana  Kavećan; Isidora Vujčić; Nataša  Maksimović; Katarina  Maksimović; Biljana  Georgievski-Brkić; Jadranka Maksimović

doi:10.5937/zdravzast53-54935

Milivoje Djurić General hospital ”Laza K. Lazarević” Šabac, Serbia
Mirjana Makević Djurić Community health centre ”DarinkaLukić” Koceljeva, Serbia
Ivana Kavećan Institute for Children and Youth Health Care of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Isidora Vujčić Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Nataša Maksimović Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Katarina Maksimović Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Biljana Georgievski-Brkić Special Hospital ”Sveti Sava”, Belgrade, Serbia
Jadranka Maksimović Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Republic of Serbia

DOI: https://doi.org/10.5937/zdravzast53-54935

Keywords: COVID-19, comorbidities, risk factors, disease severity, assisted ventilation

Abstract

Background/aim: In the clinical picture of COVID-19 respiratory symptomatology dominates, but it is basically a multisystemic disorder. The aim of this study was to identify predictors of severe forms of COVID-19 defined as the need for assisted ventilation (non-invasive or invasive mechanical ventilation).

Methods: The research was conducted as a retrospective cohort study at the General hospital "Laza K. Lazarević” in Šabac for the period from1.4.2020. to 14.11.2020. The relationship between demographic and clinical parameters of patients and the need for assisted ventilation was examined by logistic regression analysis.

Results: The study included 516 patients, 334 male subjects (64.7%), with the age of 60 and over (52.7%). The most commonly reported symptoms were fever (89%) and generalized weakness (68.8%). Mechanical ventilation was required by 44 patients, majority of whom were male (64.7%). The dominant comorbidities in mechanically ventilated group were hypertension (63.6%) and diabetes (22.7%). According to multivariate analysis independent risk factors for assisted ventilation were: fever (p=0.016), duration of illness more than seven days before hospitalization (p=0.023), oxygen saturation (sO2) <90% (p=0.002), arrhythmia(p=0.001), leukocytosis(p=0.034), and CRP≥50 mg/l (p=0.002).

Conclusion: The risk of assisted ventilation was higher in patients with fever, sO2<90% on admission to hospital, duration of illness more than seven days before hospitalization, arrhythmia, leukocytosis, lymphopenia<1.0x10⁹and CRP>50 mg/l.

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