Mortality predictors of hospitalized patients with COVID-19: Retrospective cohort study from Nur-Sultan, Kazakhstan
Pya Y. Bekbossynova M. Gaipov A. Lesbekov T. Kapyshev T. Kuanyshbek A. Tauekelova A. Litvinova L. Sailybayeva A. Vakhrushev I. Sarria-Santamera A.
December 2021Public Library of Science
PLoS ONE
2021#16Issue 12 December
Background First reported case of Severe acute respiratory syndrome-related coronavirus 2 (SARSCoV- 2) in Kazakhstan was identified in March 2020. Many specialized tertiary hospitals in Kazakhstan including National Research Cardiac Surgery Center (NRCSC) were re-organized to accept coronavirus disease 2019 (COVID-19) infected patients during summer months of 2020. Although many studies from worldwide reported their experience in treating patients with COVID-19, there are limited data available from the Central Asia countries. The aim of this study is to identify predictors of mortality associated with COVID-19 in NRCSC tertiary hospital in Nur-Sultan, Kazakhstan. Methods This is a retrospective cohort study of patients admitted to the NRCSC between June 1st- August 31st 2020 with COVID-19. Demographic, clinical and laboratory data were collected from electronic records. In-hospital mortality was assessed as an outcome. Patients were followed-up until in-hospital death or discharge from the hospital. Descriptive statistics and factors associated with mortality were assessed using univariate and multivariate logistic regression models. Results Two hundred thirty-nine admissions were recorded during the follow-up period. Mean age was 57 years and 61% were males. Median duration of stay at the hospital was 8 days and 34 (14%) patients died during the hospitalization. Non-survivors were more likely to be admitted later from the disease onset, with higher fever, lower oxygen saturation and increased respiratory rate compared to survivors. Leukocytosis, lymphopenia, anemia, elevated liver and kidney function tests, hypoproteinemia, elevated inflammatory markers (Creactive protein (CRP), ferritin, and lactate dehydrogenase (LDH)) and coagulation tests (fibrinogen, D-dimer, international normalized ratio (INR), and activated partial thromboplastin time (aPTT)) at admission were associated with mortality. Age (OR 1.2, CI:1.01-1.43), respiratory rate (OR 1.38, CI: 1.07-1.77), and CRP (OR 1.39, CI: 1.04-1.87) were determined to be independent predictors of mortality. Conclusion This study describes 14% mortality rate from COVID-19 in the tertiary hospital. Many abnormal clinical and laboratory variables at admission were associated with poor outcome. Age, respiratory rate and CRP were found to be independent predictors of mortality. Our finding would help healthcare providers to predict the risk factors associated with high risk of mortality. Further investigations involving large cohorts should be provided to support our findings.
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Department of Cardiac Surgery, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
Department of Cardiology, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
Center of Excellence, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
Department of Anesthesiology, Reanimation and Intensive Care Unit, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
Quality and Risk Management Department, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
Research Department, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
Department of Cardiac Surgery
Department of Cardiology
Department of Medicine
Center of Excellence
Department of Anesthesiology
Quality and Risk Management Department
Research Department
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