10 December 2022 : Clinical Research
Retrospective Study to Identify Risk Factors for Severe Disease and Mortality Using the Modified Early Warning Score in 5127 Patients with COVID-19 Admitted to an Emergency Department in Poland Between March 2020 and April 2021
Sławomir Butkiewicz1ABDEF, Artur Zaczyński2B, Igor Pańkowski1B, Piotr Tomaka3DF, Ewa Rzońca4DF, Daniel Ślęzak
5F, Marcin Podgórski6D, Robert Gałązkowski6DF, Jarosław Hiczkiewicz 7D, Patryk Rzońca8ACDEF*
DOI: 10.12659/MSM.938647
Med Sci Monit 2022; 28:e938647
Table 4 Results of the multivariate Cox proportional hazards model to predict mortality in patients with COVID-19 (from March 1, 2020, to April 30, 2021).
| Variable | HRc | 95% CI | p-value | HRa | 95% CI | p-value |
|---|---|---|---|---|---|---|
| Age >60 | 2.47 | 2.11–2.90 | <0.001 | 2.27 | 1.94–2.67 | <0.001 |
| Sex (Male) | 1.13 | 1.00–1.27 | 0.052 | – | – | – |
| Fever (>38°C) | 0.57 | 0.49–0.66 | <0.001 | – | – | – |
| Cough | 0.52 | 0.45–0.61 | <0.001 | 0.72 | 0.62–0.85 | <0.001 |
| Muscle pain | 0.33 | 0.23–0.45 | <0.001 | 0.60 | 0.43–0.86 | 0.005 |
| Diarrhea | 0.65 | 0.49–0.86 | 0.002 | – | – | – |
| Chest/back pain | 0.50 | 0.37–0.69 | <0.001 | – | – | – |
| Loss/change in sense of taste | 0.34 | 0.23–0.51 | <0.001 | – | – | – |
| Loss/change in sense of smell | 0.34 | 0.24–0.49 | <0.001 | 0.59 | 0.41–0.85 | 0.005 |
| Headache | 0.32 | 0.23–0.45 | <0.001 | 0.58 | 0.41–0.83 | 0.003 |
| Diabetes | 1.09 | 0.93–1.29 | 0.296 | – | – | – |
| Hypertension | 0.84 | 0.73–0.96 | 0.010 | 0.72 | 0.62–0.84 | <0.001 |
| Acute coronary syndromes | 1.02 | 0.82–1.27 | 0.844 | – | – | – |
| Stroke history | 1.05 | 0.84–1.31 | 0.682 | – | – | – |
| Cancer | 1.27 | 1.00–1.61 | 0.049 | 1.39 | 1.10–1.76 | 0.005 |
| Heart failure | 1.24 | 1.03–1.48 | 0.021 | 1.31 | 1.07–0.61 | 0.009 |
| Chronic obstructive pulmonary disease | 1.06 | 0.77–1.46 | 0.728 | – | – | – |
| Renal failure | 1.22 | 1.01–1.48 | 0.040 | 1.37 | 1.11–1.69 | 0.004 |
| Ventilator therapy | 1.53 | 1.25–1.84 | <0.001 | 1.23 | 1.01–1.49 | 0.036 |
| Nasal high-flow therapy | 0.93 | 0.80–1.08 | 0.333 | – | – | – |
| Intensive care unit admission | 2.26 | 1.98–2.58 | <0.001 | 2.33 | 2.05–2.65 | <0.001 |
| MEWS ≥5 | 1.61 | 1.44–1.81 | <0.001 | 1.43 | 1.18–1.73 | <0.001 |
| WBC count >10 | 2.88 | 2.34–3.54 | <0.001 | |||
| RBC count <4 | 2.30 | 1.80–2.95 | <0.001 | 3.17 | 2.22–4.53 | <0.001 |
| Hemoglobin <7 | 3.65 | 1.88–7.08 | <0.001 | – | – | – |
| Hematocrit <40% (male) 37% (female) | 1.38 | 1.06–1.81 | 0.017 | – | – | – |
| Platelet count <150 | 1.88 | 1.47–2.39 | <0.001 | – | – | – |
| Neutrophil count >8 | 3.64 | 2.89–4.58 | <0.001 | 2.29 | 1.57–3.35 | <0.001 |
| Lymphocyte count <1.1 | 3.76 | 2.90–4.88 | <0.001 | 2.05 | 1.55–2.71 | <0.001 |
| Monocyte count <0.1 | 4.88 | 3.66–6.51 | <0.001 | – | – | – |
| Percentage of lung parenchyma affected >50% | 2.02 | 1.69–2.40 | <0.001 | 2.10 | 1.36–3.24 | 0.001 |
| Diastolic blood pressure <60 | 2.52 | 1.86–3.41 | <0.001 | – | – | – |
| MAP <70 | 3.56 | 2.25–5.63 | <0.001 | 2.17 | 1.18–3.98 | 0.013 |
| Heart rate >125 | 2.65 | 1.85–3.79 | <0.001 | – | – | – |
| Respiratory rate >24 | 3.60 | 2.60–4.99 | <0.001 | 2.10 | 1.39–3.15 | <0.001 |
| Oxygen saturation <92 | 3.27 | 2.58–4.15 | <0.001 | 2.65 | 1.83–3.84 | <0.001 |
| HRc – crude hazard ratio; HRa – adjusted hazard ratio; 95% CI – 95% confidence interval; MEWS – modified early warning score; WBC – white blood cells; RBC – red blood cells; MAP – mean arterial pressure. | ||||||