Prediction of mortality in hospitalized Egyptian patients with Coronavirus disease-2019: A multicenter retrospective study

{ 'indexed': {'date-parts': [[2022, 1, 12]], 'date-time': '2022-01-12T05:58:29Z', 'timestamp': 1641967109499}, 'reference-count': 45, 'publisher': 'Public Library of Science (PLoS)', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2022, 1, 11]], 'date-time': '2022-01-11T00:00:00Z', 'timestamp': 1641859200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': ['www.plosone.org'], 'crossmark-restriction': False}, 'short-container-title': ['PLoS ONE'], 'abstract': '<jats:p>We aimed to assess the epidemiological, clinical, and laboratory characteristics ' 'associated with mortality among hospitalized Egyptian patients with COVID-19. A multicenter, ' 'retrospective study was conducted on all polymerase chain reaction (PCR)-confirmed COVID-19 ' 'cases admitted through the period from April to July 2020. A generalized linear model was ' 'reconstructed with covariates based on predictor’s statistical significance and clinically ' 'relevance. The odds ratio (OR) was calculated by using stepwise logistic regression modeling. ' 'A total of 3712 hospitalized patients were included; of them, 900 deaths were recorded ' '(24.2%). Compared to survived patients, non-survived patients were more likely to be older ' 'than 60 years (65.7%), males (53.6%) diabetic (37.6%), hypertensive (37.2%), and had chronic ' 'renal insufficiency (9%). Non-survived patients were less likely to receive azithromycin (p ' '&lt;0.001), anticoagulants (p &lt;0.001), and steroids (p &lt;0.001). We found that age ≥ 60 ' 'years old (OR = 2.82, 95% CI 2.05–3.86; p &lt;0.0001), diabetes mellitus (OR = 1.58, 95% CI ' '1.14–2.19; p = 0.006), hypertension (OR = 1.69, 95% CI 1.22–2.36; p = 0.002), chronic renal ' 'insufficiency (OR = 3.15, 95% CI 1.84–5.38; p &lt;0.0001), tachycardia (OR = 1.65, 95% CI ' '1.22–2.23; p &lt;0.001), hypoxemia (OR = 5.69, 95% CI 4.05–7.98; p &lt;0.0001), GCS &lt;13 ' '(OR 515.2, 95% CI 148.5–1786.9; p &lt;0.0001), the use of therapeutic dose of anticoagulation ' '(OR = 0.4, 95% CI 0.22–0.74, p = 0.003) and azithromycin (OR = 0.16, 95% CI 0.09–0.26; p ' '&lt;0.0001) were independent negative predictors of mortality. In conclusion, age &gt;60 ' 'years, comorbidities, tachycardia, hypoxemia, and altered consciousness level are independent ' 'predictors of mortality among Egyptian hospitalized patients with COVID-19. On the other ' 'hand, the use of anticoagulants and azithromycin is associated with reduced ' 'mortality.</jats:p>', 'DOI': '10.1371/journal.pone.0262348', 'type': 'journal-article', 'created': {'date-parts': [[2022, 1, 11]], 'date-time': '2022-01-11T18:52:15Z', 'timestamp': 1641927135000}, 'page': 'e0262348', 'update-policy': 'http://dx.doi.org/10.1371/journal.pone.corrections_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': [ 'Prediction of mortality in hospitalized Egyptian patients with Coronavirus disease-2019: A ' 'multicenter retrospective study'], 'prefix': '10.1371', 'volume': '17', 'author': [ {'given': 'Muhammad M.', 'family': 'AbdelGhaffar', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-5513-6955', 'authenticated-orcid': True, 'given': 'Dalia', 'family': 'Omran', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ahmed', 'family': 'Elgebaly', 'sequence': 'additional', 'affiliation': []}, {'given': 'Eshak I.', 'family': 'Bahbah', 'sequence': 'additional', 'affiliation': []}, {'given': 'Shimaa', 'family': 'Afify', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mohamed', 'family': 'AlSoda', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mohamed', 'family': 'El-Shiekh', 'sequence': 'additional', 'affiliation': []}, {'given': 'Enass S.', 'family': 'ElSayed', 'sequence': 'additional', 'affiliation': []}, {'given': 'Soha S.', 'family': 'Shaaban', 'sequence': 'additional', 'affiliation': []}, {'given': 'Samah', 'family': 'AbdelHafez', 'sequence': 'additional', 'affiliation': []}, {'given': 'Khaled', 'family': 'Elkelany', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ayman A.', 'family': 'Eltayar', 'sequence': 'additional', 'affiliation': []}, {'given': 'Omnia S.', 'family': 'Ali', 'sequence': 'additional', 'affiliation': []}, {'given': 'Lamiaa', 'family': 'Kamal', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ahmed M.', 'family': 'Heiba', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ahmad', 'family': 'El Askary', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-0928-4738', 'authenticated-orcid': True, 'given': 'Hend Ibrahim', 'family': 'Shousha', 'sequence': 'additional', 'affiliation': []}], 'member': '340', 'published-online': {'date-parts': [[2022, 1, 11]]}, 'reference': [ { 'issue': '10223', 'key': 'pone.0262348.ref001', 'doi-asserted-by': 'crossref', 'first-page': '497', 'DOI': '10.1016/S0140-6736(20)30183-5', 'article-title': 'Clinical features of patients infected with 2019 novel coronavirus in ' 'Wuhan, China.', 'volume': '395', 'author': 'C Huang', 'year': '2020', 'journal-title': 'Lancet.'}, { 'key': 'pone.0262348.ref002', 'doi-asserted-by': 'crossref', 'first-page': '25', 'DOI': '10.1016/j.cytogfr.2020.05.003', 'article-title': 'The cytokine storm in COVID-19: An overview of the involvement of the ' 'chemokine/chemokine-receptor system', 'volume': '53', 'author': 'F Coperchini', 'year': '2020', 'journal-title': 'Cytokine Growth Factor Rev'}, { 'issue': '5', 'key': 'pone.0262348.ref003', 'doi-asserted-by': 'crossref', 'first-page': '105954', 'DOI': '10.1016/j.ijantimicag.2020.105954', 'article-title': 'Cytokine release syndrome in severe COVID-19: interleukin-6 receptor ' 'antagonist tocilizumab may be the key to reduce mortality', 'volume': '55', 'author': 'C Zhang', 'year': '2020', 'journal-title': 'Int J Antimicrob Agents'}, { 'issue': '7', 'key': 'pone.0262348.ref004', 'doi-asserted-by': 'crossref', 'first-page': '819', 'DOI': '10.1001/jamacardio.2020.1096', 'article-title': 'Cardiac Involvement in a Patient With Coronavirus Disease 2019 ' '(COVID-19).', 'volume': '5', 'author': 'RM Inciardi', 'journal-title': 'JAMA Cardiol. 2020'}, { 'key': 'pone.0262348.ref005', 'doi-asserted-by': 'crossref', 'first-page': '189', 'DOI': '10.3389/fpubh.2020.00189', 'article-title': 'Severe COVID-19: A Review of Recent Progress with a Look toward the ' 'future', 'volume': '8', 'author': 'P Xie', 'year': '2020', 'journal-title': 'Front Public Health'}, { 'key': 'pone.0262348.ref006', 'unstructured': 'European Centre for Disease Prevention and Control. Situation update ' 'worldwide, as of week 1 2021. 2021. Available at: ' 'https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases.'}, { 'issue': '18', 'key': 'pone.0262348.ref007', 'doi-asserted-by': 'crossref', 'first-page': '1708', 'DOI': '10.1056/NEJMoa2002032', 'article-title': 'Clinical Characteristics of Coronavirus Disease 2019 in China', 'volume': '382', 'author': 'WJ Guan', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'issue': '6', 'key': 'pone.0262348.ref008', 'doi-asserted-by': 'crossref', 'first-page': '669', 'DOI': '10.1016/S1473-3099(20)30243-7', 'article-title': 'Estimates of the severity of coronavirus disease 2019: a model-based ' 'analysis', 'volume': '20', 'author': 'R Verity', 'journal-title': 'Lancet Infect Dis. 2020'}, { 'key': 'pone.0262348.ref009', 'doi-asserted-by': 'crossref', 'first-page': '11', 'DOI': '10.1038/s41421-020-0147-1', 'article-title': 'Comparative genetic analysis of the novel coronavirus ' '(2019-nCoV/SARS-CoV-2) receptor ACE2 in different populations', 'volume': '6', 'author': 'Y Cao', 'year': '2020', 'journal-title': 'Cell Discov'}, { 'key': 'pone.0262348.ref010', 'doi-asserted-by': 'crossref', 'article-title': 'Asians Do Not Exhibit Elevated Expression or Unique Genetic ' 'Polymorphisms for ACE2, the Cell-Entry Receptor of SARS-CoV-2', 'author': 'Y Chen', 'year': '2020', 'DOI': '10.20944/preprints202002.0258.v2'}, { 'key': 'pone.0262348.ref011', 'doi-asserted-by': 'crossref', 'first-page': '101205', 'DOI': '10.1016/j.arr.2020.101205', 'article-title': 'Aging in COVID-19: Vulnerability, immunity and intervention', 'volume': '65', 'author': 'Y Chen', 'year': '2021', 'journal-title': 'Ageing Res Rev'}, { 'issue': '1', 'key': 'pone.0262348.ref012', 'doi-asserted-by': 'crossref', 'first-page': '484', 'DOI': '10.1186/s12889-021-10427-2', 'article-title': 'UK prevalence of underlying conditions which increase the risk of ' 'severe COVID-19 disease: a point prevalence study using electronic ' 'health records', 'volume': '21', 'author': 'JL Walker', 'year': '2021', 'journal-title': 'BMC Public Health'}, { 'key': 'pone.0262348.ref013', 'doi-asserted-by': 'crossref', 'first-page': '29', 'DOI': '10.1186/s13293-020-00304-9', 'article-title': 'Impact of sex and gender on COVID-19 outcomes in Europe', 'volume': '11', 'author': 'C Gebhard', 'year': '2020', 'journal-title': 'Biol Sex Differ'}, { 'issue': '11', 'key': 'pone.0262348.ref014', 'doi-asserted-by': 'crossref', 'first-page': '5327', 'DOI': '10.4049/jimmunol.1501684', 'article-title': 'Sex differences in plasmacytoid dendritic cell levels of Irf5 drive ' 'higher Ifn-alpha production in women', 'volume': '195', 'author': 'M Griesbeck', 'year': '2015', 'journal-title': 'J Immunol'}, { 'key': 'pone.0262348.ref015', 'unstructured': 'World health organization, (2021 January 20), WHO Health Emergency ' 'Dashboard, WHO (COVID-19) Homepage retrieved from: ' 'https://covid19.who.int/region/emro/country/eg.'}, { 'issue': '12', 'key': 'pone.0262348.ref016', 'doi-asserted-by': 'crossref', 'first-page': '1495', 'DOI': '10.1016/j.ijsu.2014.07.013', 'article-title': 'The Strengthening the Reporting of Observational Studies in ' 'Epidemiology (STROBE) Statement: guidelines for reporting observational ' 'studies', 'volume': '12', 'author': 'STROBE Initiative', 'year': '2014', 'journal-title': 'Int J Surg'}, { 'issue': 'Suppl 1', 'key': 'pone.0262348.ref017', 'first-page': 'S11', 'article-title': 'American Diabetes Association. Standards of medical care in ' 'diabetes—2011', 'volume': '34', 'year': '2011', 'journal-title': 'Diabetes Care'}, { 'issue': '33', 'key': 'pone.0262348.ref018', 'doi-asserted-by': 'crossref', 'first-page': '3021', 'DOI': '10.1093/eurheartj/ehy339', 'article-title': '2018 ESC/ESH Guidelines for the management of arterial hypertension', 'volume': '39', 'author': 'ESC Scientific Document Group', 'year': '2018', 'journal-title': 'Eur Heart J'}, { 'issue': '1', 'key': 'pone.0262348.ref019', 'doi-asserted-by': 'crossref', 'first-page': '5', 'DOI': '10.1038/kisup.2012.77', 'article-title': 'Summary of Recommendation Statements', 'volume': '3', 'year': '2013', 'journal-title': 'Kidney Int Suppl (2011).'}, { 'issue': '3', 'key': 'pone.0262348.ref020', 'doi-asserted-by': 'crossref', 'first-page': '170', 'DOI': '10.1016/j.aenj.2012.06.002', 'article-title': 'Practical use of the Glasgow Coma Scale; a comprehensive narrative ' 'review of GCS methodology.', 'volume': '15', 'author': 'PM Middleton', 'year': '2012', 'journal-title': 'Australas Emerg Nurs J.'}, { 'key': 'pone.0262348.ref021', 'unstructured': 'Ministry of Health and Population, Egypt Management protocol for ' 'COVID-19 Patients Version 1.4 / 30th May 2020, Available at: ' 'https://www.elwatannews.com/data/iframe/pdf/17175200761591035127.pdf.'}, { 'key': 'pone.0262348.ref022', 'unstructured': 'Worldometers.info. 2020 October 8. Dover, Delaware, U.S.A. Retrieved ' 'from: https://www.worldometers.info/coronavirus/country/egypt/.'}, { 'key': 'pone.0262348.ref023', 'doi-asserted-by': 'crossref', 'first-page': '1239', 'DOI': '10.1001/jama.2020.2648', 'article-title': 'Characteristics of and Important Lessons From the Coronavirus Disease ' '2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases ' 'From the Chinese Center for Disease Control and Prevention', 'volume': '323', 'author': 'Z Wu', 'year': '2020', 'journal-title': 'JAMA'}, { 'issue': '20', 'key': 'pone.0262348.ref024', 'doi-asserted-by': 'crossref', 'first-page': '2052', 'DOI': '10.1001/jama.2020.6775', 'article-title': 'Presenting Characteristics, Comorbidities, and Outcomes Among 5700 ' 'Patients Hospitalized With COVID-19 in the New York City Area', 'volume': '323', 'author': 'S Richardson', 'year': '2020', 'journal-title': 'JAMA'}, { 'key': 'pone.0262348.ref025', 'first-page': '1775', 'article-title': 'Case-Fatality Rate and Characteristics of Patients Dying in Relation to ' 'COVID-19 in Italy.', 'volume': '323', 'author': 'G Onder', 'year': '2020', 'journal-title': 'JAMA'}, { 'issue': '7844', 'key': 'pone.0262348.ref026', 'doi-asserted-by': 'crossref', 'first-page': '140', 'DOI': '10.1038/s41586-020-2918-0', 'article-title': 'Age-specific mortality and immunity patterns of SARS-CoV-2', 'volume': '590', 'author': 'M O’Driscoll', 'year': '2021', 'journal-title': 'Nature'}, { 'key': 'pone.0262348.ref027', 'doi-asserted-by': 'crossref', 'first-page': '4', 'DOI': '10.1016/j.exger.2017.10.024', 'article-title': 'Age and immunity: what is “immunosenescence”?', 'volume': '105', 'author': 'G Pawelec', 'year': '2018', 'journal-title': 'Exp. Gerontol'}, { 'key': 'pone.0262348.ref028', 'doi-asserted-by': 'crossref', 'first-page': '558', 'DOI': '10.1080/22221751.2020.1736644', 'article-title': 'A tug-of-war between severe acute respiratory syndrome coronavirus 2 ' 'and host antiviral defence: lessons from other pathogenic viruses', 'volume': '9', 'author': 'SY Fung', 'year': '2020', 'journal-title': 'Emerg. Microbes Infect'}, { 'issue': '11', 'key': 'pone.0262348.ref029', 'doi-asserted-by': 'crossref', 'first-page': '6141', 'DOI': '10.1172/JCI142004', 'article-title': 'Sex, age, and hospitalization drive antibody responses in a COVID-19 ' 'convalescent plasma donor population', 'volume': '130', 'author': 'SL Klein', 'year': '2020', 'journal-title': 'J Clin Invest'}, { 'key': 'pone.0262348.ref030', 'doi-asserted-by': 'crossref', 'first-page': '157', 'DOI': '10.3389/fmolb.2020.00157', 'article-title': 'Immune phenotyping based on the neutrophil-to-lymphocyte ratio and igg ' 'level predicts disease severity and outcome for patients with COVID-19', 'volume': '7', 'author': 'B Zhang', 'year': '2020', 'journal-title': 'Front. Mol. Biosci'}, { 'key': 'pone.0262348.ref031', 'doi-asserted-by': 'crossref', 'first-page': '459', 'DOI': '10.3389/fmed.2020.00459', 'article-title': 'COVID-19 Clinical Characteristics, and Sex-Specific Risk of Mortality: ' 'Systematic Review and Meta-Analysis.', 'volume': '7', 'author': 'MJ Nasiri', 'year': '2020', 'journal-title': 'Front Med (Lausanne).'}, { 'key': 'pone.0262348.ref032', 'doi-asserted-by': 'crossref', 'first-page': 'm1966', 'DOI': '10.1136/bmj.m1966', 'article-title': 'Factors associated with hospital admission and critical illness among ' '5279 people with coronavirus disease 2019 in New York City: prospective ' 'cohort study', 'volume': '369', 'author': 'CM Petrilli', 'year': '2020', 'journal-title': 'BMJ'}, { 'key': 'pone.0262348.ref033', 'first-page': 'ciaa924', 'article-title': 'Association between male sex and outcomes of Coronavirus Disease 2019 ' '(Covid-19)—a Danish nationwide, register-based study', 'author': 'K Kragholm', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'key': 'pone.0262348.ref034', 'doi-asserted-by': 'crossref', 'first-page': 'm1091', 'DOI': '10.1136/bmj.m1091', 'article-title': 'Clinical characteristics of 113 deceased patients with coronavirus ' 'disease 2019: retrospective study', 'volume': '368', 'author': 'T Chen', 'year': '2020', 'journal-title': 'BMJ'}, { 'issue': '2', 'key': 'pone.0262348.ref035', 'doi-asserted-by': 'crossref', 'first-page': '271', 'DOI': '10.1016/j.cell.2020.02.052', 'article-title': 'SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a ' 'Clinically Proven Protease Inhibitor', 'volume': '181', 'author': 'M Hoffmann', 'year': '2020', 'journal-title': 'Cell'}, { 'issue': '1', 'key': 'pone.0262348.ref036', 'doi-asserted-by': 'crossref', 'first-page': '6317', 'DOI': '10.1038/s41467-020-19741-6', 'article-title': 'Male sex identified by global COVID-19 meta-analysis as a risk factor ' 'for death and ITU admission', 'volume': '11', 'author': 'H Peckham', 'year': '2020', 'journal-title': 'Nat Commun'}, { 'key': 'pone.0262348.ref037', 'doi-asserted-by': 'crossref', 'first-page': 'm1985', 'DOI': '10.1136/bmj.m1985', 'article-title': 'Features of 20\u2009133 UK patients in hospital with covid-19 using the ' 'ISARIC WHO Clinical Characterisation Protocol: prospective ' 'observational cohort study', 'volume': '369', 'author': 'AB Docherty', 'year': '2020', 'journal-title': 'BMJ'}, { 'issue': '9', 'key': 'pone.0262348.ref038', 'doi-asserted-by': 'crossref', 'first-page': 'e1003321', 'DOI': '10.1371/journal.pmed.1003321', 'article-title': 'Comorbidities associated with mortality in 31,461 adults with COVID-19 ' 'in the United States: A federated electronic medical record analysis', 'volume': '17', 'author': 'SL Harrison', 'year': '2020', 'journal-title': 'PLoS Med'}, { 'key': 'pone.0262348.ref039', 'doi-asserted-by': 'crossref', 'first-page': '91', 'DOI': '10.1016/j.ijid.2020.03.017', 'article-title': 'Prevalence of comorbidities and its effects in patients infected with ' 'SARS-CoV-2: a systematic review and meta-analysis', 'volume': '94', 'author': 'J Yang', 'year': '2020', 'journal-title': 'Int J Infect Dis'}, { 'issue': '20', 'key': 'pone.0262348.ref040', 'first-page': '30585', 'article-title': 'Clinical Characteristics and Outcomes of COVID-19 among Patients with ' 'Pre-Existing Liver Disease in United States: A Multi-Center Research ' 'Network Study', 'author': 'S Singh', 'year': '2020', 'journal-title': 'Gastroenterology'}, { 'issue': '5', 'key': 'pone.0262348.ref041', 'doi-asserted-by': 'crossref', 'first-page': '100169', 'DOI': '10.1016/j.jhepr.2020.100169', 'article-title': 'Impact of COVID-19 on the care of patients with liver disease: ' 'EASL-ESCMID position paper after 6 months of the pandemic.', 'volume': '2', 'author': 'T Boettler', 'year': '2020', 'journal-title': 'JHEP Rep'}, { 'issue': '1', 'key': 'pone.0262348.ref042', 'doi-asserted-by': 'crossref', 'first-page': '11', 'DOI': '10.1038/s41574-020-00435-4', 'article-title': 'COVID-19 and diabetes mellitus: from pathophysiology to clinical ' 'management', 'volume': '17', 'author': 'S Lim', 'year': '2021', 'journal-title': 'Nat Rev Endocrinol'}, { 'issue': '11', 'key': 'pone.0262348.ref043', 'doi-asserted-by': 'crossref', 'first-page': '2467', 'DOI': '10.1016/j.mayocp.2020.08.030', 'article-title': 'Anticoagulation in COVID-19: A Systematic Review, Meta-analysis, and ' 'Rapid Guidance From Mayo Clinic', 'volume': '95', 'author': 'RD McBane', 'year': '2020', 'journal-title': 'Mayo Clin Proc'}, { 'issue': '4', 'key': 'pone.0262348.ref044', 'doi-asserted-by': 'crossref', 'first-page': '217', 'DOI': '10.2478/jccm-2020-0033', 'article-title': 'Anticoagulation in COVID—19: An Update.', 'volume': '6', 'author': 'NR Tiwari', 'year': '2020', 'journal-title': 'J Crit Care Med (Targu Mures).'}, { 'key': 'pone.0262348.ref045', 'article-title': 'Coronavirus disease 2019 (COVID-19): Hypercoagulability', 'author': 'A Cuker', 'year': '2020', 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