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Prognostic factors of 30-day mortality in patients with COVID-19 pneumonia under standard remdesivir and dexamethasone treatmentopen access

Authors
Choi, Yu JungSong, Joon YoungHyun, HakjunNham, ElielYoon, Jin GuSeong, HyeNoh, Ji YunCheong, Hee JinKim, Woo Joo
Issue Date
23-9월-2022
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
COVID-19; mortality; pneumonia; prognosis; SARS-CoV-2
Citation
MEDICINE, v.101, no.38, pp.E30474
Indexed
SCIE
SCOPUS
Journal Title
MEDICINE
Volume
101
Number
38
Start Page
E30474
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/145735
DOI
10.1097/MD.0000000000030474
ISSN
0025-7974
Abstract
Although some studies have reported prognostic factors for coronavirus disease 2019 (COVID-19), they were conducted before standard treatment with remdesivir and dexamethasone was implemented. This retrospective, observational study was conducted to evaluate various prognostic factors in patients with COVID-19 pneumonia receiving standard treatment with remdesivir and dexamethasone. Of 99 patients with COVID-19 pneumonia, 68 (68.7%) died within 30 days of hospitalization. The mean age was 71.3 years. Remdesivir and dexamethasone were administered to 80 (80.8%) and 84 (84.8%) patients, respectively. Early antibiotic treatment was administered to 70 patients (70.7%) within 5 days of hospitalization. Dexamethasone (79.4% vs 96.8%, P = .033) was more frequently administered in the survived group, whereas early antibiotics (60.3% vs 93.5%, P = .001) were less frequently administered. In the multivariate analysis, a high National Early Warning Score (NEWS; odds ratio [OR] 1.272), high Charlson Comorbidity Index (CCI; OR 1.441), and dyspnea (OR 4.033) were independent risk factors for 30-day mortality. There was no significant difference in age, sex, and vaccination doses between the survived and fatal groups. Lymphopenia, monocytopenia and high levels of C-reactive protein (CRP)/lactate dehydrogenase (LDH) reflected poor prognosis. NEWS, CCI, and dyspnea were predictors of 30-day mortality in patients with COVID-19 pneumonia. Early antibiotic use did not lower the 30-day mortality risk.
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