Resumen

Causes of death in patients with COVID-19: the HUBCOVID365 cohort findings

Arantxa Albert¹, Javier Jacob^1-3, José Carlos Ruibal¹, Pierre Malchair¹, Ferrán Llopis¹, Carles Ferre¹ en representación del Grupo de Trabajo sobre la atención de la COVID-19 en Urgencias (HUBCOVID365).

Filiación de los autores

¹Servicio de Urgencias, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona. ²Universitat de Barcelona, Spain.³Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Spain.

DOI

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Cita

Albert A, Jacob J, Ruibal JC, Malchair P, Llopis F, Ferre C. Causes of death in patients with COVID-19: the HUBCOVID365 cohort findings. Rev Esp Urg Emerg. 2023;2:132–9

Resumen

OBJECTIVES. To describe the causes of death in patients with COVID-19, analyze risk factors, and explore whether predictors differed according to cause of death.
MATERIAL AND METHODS. Data for the study cohort was gathered retrospectively by the working group on emergency care for patients with COVID-19 (HUBCOVID365) between March 1 and April 30, 2020. The group studied predictors of death from different causes and calculated adjusted odds ratios (ORs). Differences between 4 causes of death were analyzed, and 1-year survival curves were constructed.
RESULTS. We included 1601 patients and identified 276 deaths (17.6%): 209 deaths (75.7%) were due to a single lung injury, 34 (12.3%) were due to sepsis, 24 (8.7%) to cardiovascular complications, and 9 (3.3%) to other events. The adjusted ORs (95% CIs) for predictors of mortality overall and death due to lung injury, respectively, were age, 1.09 (1.06-1.12) and 1.11 (1.07-1.15); dyspnea 2.75 (1.68-4.51) and 2.08 (1.18-3.66); systolic blood pressure less than 100 mmHg, 3.82 (1.77-8.23) and 3.27 (1.36-7.84); respiratory rate over 24 rpm, 1.72 (1.05-2.79) and 2.21 (1.27-3.84); resting oxygen saturation less than 92%, 2.54 (1.48-4.37) and 2.34 (1.28-4.28); and D-dimer level 1000 ng/mL or higher, 2.69 (1.55-4.69) and 2.12 (1.14-3.93). Mortality attributed to sepsis was associated with intensive care unit admission and invasive mechanical ventilation. The survival curve for lung injury was significantly different from the others.
CONCLUSION. Patients with COVID-19 died mainly because of lung injury. Sepsis was the second most frequent cause of death. We detected few differences in predictors of death from different causes. These findings suggest that protocols for general measures to prevent thrombotic and septic complications should be continued for all patients with severe COVID-19.