Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study
van Halem et al.
, Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a..
, BMC Infect Dis., doi:10.1186/s12879-020-05605-3
Retrospective 319 hospitalized patients in Belgium showing lower mortality with HCQ, although not reported to be statistically significant.
Although the 32% lower mortality is not statistically significant, it is consistent with the significant 22% lower mortality [18‑27%]
from meta analysis of the 232 mortality results to date
risk of death, 31.6% lower, RR 0.68, p = 0.05, treatment 34 of 164 (20.7%), control 47 of 155 (30.3%), NNT 10.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
van Halem et al., 27 Nov 2020, retrospective, Belgium, peer-reviewed, 10 authors.
Abstract: van Halem et al. BMC Infectious Diseases
Risk factors for mortality in hospitalized
patients with COVID-19 at the start of the
pandemic in Belgium: a retrospective
Karlijn van Halem1* , Robin Bruyndonckx2,3, Jeroen van der Hilst1,4, Janneke Cox1,4, Paulien Driesen1,
Matthias Opsomer1, Eveline Van Steenkiste1, Björn Stessel5, Jasperina Dubois5 and Peter Messiaen1,4
Background: Belgium was among the first countries in Europe with confirmed coronavirus disease 2019 (COVID19) cases. Since the first diagnosis on February 3rd, the epidemic has quickly evolved, with Belgium at the
crossroads of Europe, being one of the hardest hit countries. Although risk factors for severe disease in COVID-19
patients have been described in Chinese and United States (US) cohorts, good quality studies reporting on clinical
characteristics, risk factors and outcome of European COVID-19 patients are still scarce.
Methods: This study describes the clinical characteristics, complications and outcomes of 319 hospitalized COVID19 patients, admitted to a tertiary care center at the start of the pandemic in Belgium, and aims to identify the
main risk factors for in-hospital mortality in a European context using univariate and multivariate logistic regression
Results: Most patients were male (60%), the median age was 74 (IQR 61–83) and 20% of patients were admitted to
the intensive care unit, of whom 63% needed invasive mechanical ventilation. The overall case fatality rate was
25%. The best predictors of in-hospital mortality in multivariate analysis were older age, and renal insufficiency,
higher lactate dehydrogenase and thrombocytopenia. Patients admitted early in the epidemic had a higher
mortality compared to patients admitted later in the epidemic. In univariate analysis, patients with obesity did have
an overall increased risk of death, while overweight on the other hand showed a trend towards lower mortality.
Conclusions: Most patients hospitalized with COVID-19 during the first weeks of the epidemic in Belgium were
admitted with severe disease and the overall case fatality rate was high. The identified risk factors for mortality are
not easily amenable at short term, underscoring the lasting need of effective therapeutic and preventative
Keywords: COVID-19, Coronavirus, Clinical characteristics, Mortality
* Correspondence: firstname.lastname@example.org
Department of Infectious Diseases and Immunity, Jessa Hospital,
Stadsomvaart 11, 3500 Hasselt, Belgium
Full list of author information is available at the end of the article
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