Determining the time of maximum risk of death and associated factors in patients with COVID-19 in the hospital and after discharge

Abstract

Due to the rather specific course of COVID-19, the question of what day after the start of hospitalization should be expected to be the maximum risk of death in patients both during hospitalization and after discharge is relevant.Aim. The aim of the study was to determine the time of maximum risk of death during hospitalization of patients with COVID-19 as well as after their discharge from the hospital.Methodology and Research Methods. A total of 2,410 patients hospitalized with a diagnosis of COVID-19 were retrospectively studied. Inhospital 28-day mortality rate was 131 patients, and 28-day mortality rate after discharge from the hospital was 9. The accelerated failure time model (AFT) was used to determine the time of maximum risk of death in patients with COVID-19 after hospitalization as well as after discharge from the hospital during the period up to 28 days.Results. Without taking into account the influence of pathological values of other risk factors, lethal outcomes in patients occurred on days 9-11 after admission to hospital. Age over 60 years and the elevated levels of D-dimer, glucose, urea, creatinine, AST, and C-reactive protein were the risk factors (p < 0.01) that shortened the time to death, except for total protein, which lengthened this period. The maximum risk of death in patients after discharge from the hospital occurred on days 13-25, and an increase in creatinine and a decrease in INR were associated with a shorter time to death.Conclusion. The periods of maximum risk of death as well as the factors affecting these periods in patients with COVID-19 were determined for both hospital stay (days 9-11) and time after discharge from hospital (days 13-25).