Primary Analysis of the Risk Factors for Severity and Mortality in COVID-19 Patients in Uzbekistan

  • Visolatkhon Sharipova Republican Research Centre of Emergency Medicine, Tashkent, Uzbekistan.
  • Khikmat Anvarov Republican Research Centre of Emergency Medicine, Tashkent, Uzbekistan.
  • Abdusalom Abdurakhmanov Republican Research Centre of Emergency Medicine, Tashkent, Uzbekistan.
  • Azamat Alimov Republican Research Centre of Emergency Medicine, Tashkent, Uzbekistan.
  • Nurbek Iskhakov Republican Research Centre of Emergency Medicine, Tashkent, Uzbekistan.
Keywords: Coronavirus Infection, Mortality Risk Factors, Severe Course, Mortality Prediction

Abstract

A retrospective analysis of 561 patients with confirmed COVID-19 was performed to determine the risk factors for severity and mortality which could predict the disease outcome in early stages. Patients were divided into 4 groups in accordance with disease severity: mild, moderate, severe and critical. And initial clinical and laboratory parameters of patients at admission were studied. The age of severe and deceased patients was significantly higher than patients with mild and moderate course (р=0.003). Patiens with severe disease and fatal outcome had higher incidence of concomitant diseases compared to patients with mild and moderate course (p=0.01). The time passed from onset of first symptoms and hospital admission was shorter in patients with mild and moderate disease than patients with severe and critical disease (р=0.0001). The leukocytosis, significant lymphopenia (р=0.0001), high D-dimer and ferritin levels were associated with severe disease. Male gender, old age, presence of concomitant diseases should be considered as risk factors for severe course and death at COVID-19.

How to cite this article:
Sharipova V, Anvarov K, Abdurakhmanov A, Alimov A, Iskhakov N. Primary Analysis of the Risk Factors for Severity and Mortality in COVID-19 Patients in Uzbekistan. J Commun Dis. 2021;53(3):104-111.

DOI: https://doi.org/10.24321/0019.5138.202145

References

Coronavirus (COVID-19) Information and Updates - John Hopkins Medicine. Available from: www.

hopkinsmedicine.org/coronavirus/.

Vetter P, Vu DL, L’Huillier AG, Schibler M, Kaiser L, Jacquerioz F. Clinical features of COVID-19. BMJ. 2020

Apr;369:m1470. [PubMed] [Google Scholar]

Jordan RE, Adab P, Cheng KK. Covid-19: risk factors for severe disease and death. BMJ. 2020 Mar;368:m1198.

[PubMed] [Google Scholar]

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S,

Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 inWuhan, China: a retrospective cohort study, Lancet. 2020 Mar;395(10229):1054-62. [PubMed] [Google Scholar]

What you need to know about coronavirus infections (COVID-19)? Ministry of Health, the Republic of

Uzbekistan. Available from: https://coronavirus.uz/ru.

Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T, Guo W, Chen J, Ding C,

Zhang X, Huang J, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical characteristics of 113 deceased patients with

coronavirus disease 2019: retrospective study. BMJ. 2020 Mar;368:m1091. [PubMed] [Google Scholar]

CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19).

MMWR Morb Mortal Wkly Rep. 2020 Mar;69(12):343-6. [PubMed] [Google Scholar]

Hong KH, Choi JP, Hong SH, Lee J, Kwon JS, Kim SM, Park SY, Rhee JY, Kim BN, Choi HJ, Shin EC, Pai H, Park SH, Kim SH. Predictors of mortality in Middle East respiratory syndrome (MERS). Thorax. 2018 Mar;73(3):286-9.

[PubMed] [Google Scholar]

Choi KW, Chau TN, Tsang O, Tso E, Chiu MC, Tong WL, Lee PO, Ng TK, Ng WF, Lee KC, Lam W, Yu WC, Lai JY,

Lai ST; Princess Margaret Hospital SARS Study Group. Outcomes and prognostic factors in 267 patients with

severe acute respiratory syndrome in Hong Kong, Ann Intern Med. 2003 Nov;139(9):715-23. [PubMed]

[Google Scholar]

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, Huang H, Zhang L, Zhou X, Du C, Zhang Y, Song J, Wang S, Chao

Y, Yang Z, Xu J, Zhou X, Chen D, Xiong W, Xu L, Zhou F, Jiang J, Bai C, Zheng J, Song Y. Risk factors associated

with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in

Wuhan, China. JAMA Intern Med. 2020 Jul;180(7):934-43. [PubMed] [Google Scholar]

Opal SM, Girard TD, Ely EW. The immunopathogenesis of sepsis in elderly patients. Clin Infect Dis. 2005 Nov;41 Suppl 7:S504-12. [PubMed] [Google Scholar]

The Lancet. The gendered dimensions of COVID-19. The Lancet. 2020 Apr;395(10231):1168. [PubMed]

[Google Scholar]

Wenham C, Smith J, Morgan R. COVID-19: the gendered impacts of the outbreak. Lancet. 2020

Mar;395(10227):846-8. [PubMed] [Google Scholar]

Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med. 2020

Apr;8(4):e20. [PubMed] [Google Scholar]

Zheng QL, Duan T, Jin LP. Single-cell RNA expression profiling of ACE2 and AXL in the human maternal-fetal

interface. Reprod Dev Med. 2020;4(1):7-10. [Google Scholar]

Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk

for COVID-19 infection? Lancet Respir Med. 2020 Apr;8(4):e21. [PubMed] [Google Scholar]

Zhang JJ, Chen BS, Dai HQ, Ren JW, Zhou LW, Wu SH, Liu HW. Clinical characteristics of 140 patients

infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020 Jul;75(7):1730-41. [PubMed] [Google Scholar]

Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, Bi Z, Zhao Y. Prevalence and impact of cardiovascular metabolic

diseases on COVID-19 in China. Clin Res Cardiol. 2020 May;109(5):531-8. [PubMed] [Google Scholar]

Pal R, Bhansali A. COVID-19, Diabetes Mellitus and ACE2: The conundrum. Diabetes Res Clin Pract. 2020

Apr;162:108132. [PubMed] [Google Scholar]

Hussain A, Bhowmik B, Cristina do Vale Moreira N. COVID-19 and diabetes: Knowledge in progress.

Diabetes Res Clin Pract. 2020 Apr;162:108142. [PubMed] [Google Scholar]

Peng YD, Meng K, Guan HQ, Leng L, Zhu RR, Wang BY, He MA, Cheng LX, Huang K, Zeng QT. Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV. Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Jun;48(6):450-5. [PubMed] [Google Scholar]

Aggarwal G, Cheruiyot I, Aggarwal S, Wong J, Lippi G, Lavie CJ, Henry BM, Sanchis-Gomar F. Association of

cardiovascular disease with coronavirus disease 2019 (COVID-19) Severity: a meta-analysis. Curr Probl Cardiol.

Aug;45(8):100617. [PubMed] [Google Scholar]

Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, Quaderi S, Mandal S,

Hurst JR. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: a

rapid systematic review and meta-analysis. PLoS One. 2020 May;15(5):e0233147. [PubMed] [Google Scholar]

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen

KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng

P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment

Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020

Apr;382(18):1708-20. [PubMed] [Google Scholar]

Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y, Jiang X, Li X. C-reactive protein correlates with computed

tomographic findings and predicts severe COVID-19 early. J Med Virol. 2020 Jul;92(7):856-62. [PubMed]

[Google Scholar]

Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, Xie J, Guan W, Liang W, Ni Z, Hu Y, Liu L, Shan H, Lei C, Peng

Y, Wei L, Liu Y, Hu Y, Peng P, Wang J, Liu J, Chen Z, Li G, Zheng Z, Qiu S, Luo J, Ye C, Zhu S, Zheng J, Zhang N, Li

Y, He J, Li J, Li S, Zhong N; Medical Treatment ExpertGroup for COVID-19. Longitudinal hematologic and

immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol.

Jul;146(1):89-100. [PubMed] [Google Scholar]

Ma A, Cheng J, Yang J, Dong M, Liao X, Kang Y. Neutrophilto-lymphocyte ratio as a predictive biomarker for

moderate-severe ARDS in severe COVID-19 patients. Crit Care. 2020 Jun;24(1):288. [PubMed] [Google

Scholar]

Spiezia L, Boscolo A, Poletto F, Cerruti L, Tiberio I, Campello E, Navalesi P, Simioni P. COVID-19-related

severe hypercoagulability in patients admitted to intensive care unit for acute respiratory failure. Thromb

Haemost. 2020 Jun;120(6):998-1000. [PubMed] [Google Scholar]

Pavoni V, Gianesello L, Pazzi M, Stera C, Meconi T, Frigieri FC. Evaluation of coagulation function by rotation

thromboelastometry in critically ill patients with severe COVID-19 pneumonia. J Thromb Thrombolysis. 2020

Aug;50(2):281-6. [PubMed] [Google Scholar]

Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, De Leacy RA, Shigematsu T, Ladner TR, Yaeger KA,

Skliut M, Weinberger J, Dangayach NS, Bederson JB, Tuhrim S, Fifi JT. Large-vessel stroke as a presenting

feature of Covid-19 in the young. N Engl J Med. 2020 May;382(20):e60. [PubMed] [Google Scholar]

Xiong W, Mu J, Guo J, Lu L, Liu D, Luo J, Li N, Liu J, Yang D, Gao H, Zhang Y, Lin M, Shen S, Zhang H, Chen L,

Wang G, Luo F, Li W, Chen S, He L, Sander JW, Zhou D. New onset neurologic events in people with COVID-19

infection in three regions in China. Neurology. 2020 Sep;95(11):e1479-87. [PubMed] [Google Scholar]

Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, Aaron JG, Claassen J, Rabbani

LE, Hastie J, Hochman BR, Salazar-Schicchi J, Yip NH, Brodie D, O’Donnell MR. Epidemiology, clinical course,

and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020

Jun;395(10239):1763-70. [PubMed] [Google Scholar]

Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in

patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;4(18):844-7. [PubMed] [Google Scholar]

Li C, Hu B, Zhang Z, Qin W, Zhu Z, Zhai Z, Davidson BL, Wang C. D-dimer triage for COVID-19. Acad Emerg

Med. 2020 Jul;27(7):612-3. [PubMed] [Google Scholar]

Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, Zhang Z. D-dimer levels on admission to predict in-hospital

mortality in patients with COVID-19. J Thromb Haemost. 2020 Jun;18(6):1324-9. [PubMed] [Google Scholar]

Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune

biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019

(COVID-19): a meta-analysis. Clin Chem Lab Med. 2020 Jun;58(7):1021-8. [PubMed] [Google Scholar]

Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with

COVID-19. Lancet Haematol. 2020 Jun;7(6):e438-40. [PubMed] [Google Scholar]

Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, Xie J, Guan W, Liang W, Ni Z, Hu Y, Liu L, Shan H, Lei C, Peng

Y, Wei L, Liu Y, Hu Y, Peng P, Wang J, Liu J, Chen Z, Li G, Zheng Z, Qiu S, Luo J, Ye C, Zhu S, Zheng J, Zhang N, Li

Y, He J, Li J, Li S, Zhong N; Medical Treatment Expert Group for COVID-19. Longitudinal hematologic and

immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol.

Jul;146(1):89-100. [PubMed] [Google Scholar]

To KK, Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, Yip CC, Cai JP, Chan JM, Chik TS, Lau DP, Choi

CY, Chen LL, Chan WM, Chan KH, Ip JD, Ng AC, Poon RW, Luo CT, Cheng VC, Chan JF, Hung IF, Chen Z,

Chen H, Yuen KY. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum

antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020

May;20(5):565-74. [PubMed] [Google Scholar]

Chu CM, Poon LL, Cheng VC, Chan KS, Hung IF, Wong MM, Chan KH, Leung WS, Tang BS, Chan VL, Ng WL,

Sim TC, Ng PW, Law KI, Tse DM, Peiris JS, Yuen KY. Initial viral load and the outcomes of SARS. CMAJ.

Nov;171(11):1349-52. [PubMed] [Google Scholar]

Published
2021-09-30