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10.21037/jtd-20-2568

http://scihub22266oqcxt.onion/10.21037/jtd-20-2568
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33841931!8024856!33841931
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suck abstract from ncbi

pmid33841931      J+Thorac+Dis 2021 ; 13 (3): 1380-1395
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  • Early identification of patients with severe COVID-19 at increased risk of in-hospital death: a multicenter case-control study in Wuhan #MMPMID33841931
  • Zhou W; Liu Y; Xu B; Wang S; Li S; Liu H; Huang Z; Luo Y; Hu M; Wu W; Zhang Z; Long X; Zou W; Bian Y; Zou X; Elliott M; Yue L; Deng H; Chen H; Gao X; Wu Y; Fang M; Zhang B; Gao Y
  • J Thorac Dis 2021[Mar]; 13 (3): 1380-1395 PMID33841931show ga
  • BACKGROUND: Most evidence regarding the risk factors for early in-hospital mortality in patients with severe COVID-19 focused on laboratory data at the time of hospital admission without adequate adjustment for confounding variables. A multicenter, age-matched, case-control study was therefore designed to explore the dynamic changes in laboratory parameters during the first 10 days after admission and identify early risk indicators for in-hospital mortality in this patient cohort. METHODS: Demographics and clinical data were extracted from the medical records of 93 pairs of patients who had been admitted to hospital with severe COVID-19. These patients had either been discharged or were deceased by March 3, 2020. Data from days 1, 4, 7, and 10 of hospital admission were compared between survivors and non-survivors. Univariate and multivariate conditional logistic regression analyses were employed to identify early risk indicators of in-hospital death in this cohort. RESULTS: On admission, in-hospital mortality was associated with five risk indicators (ORs in descending order): aspartate aminotransferase (AST, >32 U/L) 43.20 (95% CI: 2.63, 710.04); C-reactive protein (CRP) greater than 100 mg/L 13.61 (1.78, 103.941); lymphocyte count lower than 0.6x10(9)/L 9.95 (1.30, 76.42); oxygen index (OI) less than 200 8.23 (1.04, 65.15); and D-dimer over 1 mg/L 8.16 (1.23, 54.34). Sharp increases in D-dimer at day 4, accompanied by decreasing lymphocyte counts, deteriorating OI, and persistent remarkably high CRP concentration were observed among non-survivors during the early stages of hospital admission. CONCLUSIONS: The potential risk factors of high D-dimer, CRP, AST, low lymphocyte count and OI could help clinicians identify patients at high risk of death early in the hospital admission. This might assist with rationalization of health care resources.
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