Decoding Adversity: Predictors of Poor Outcomes in Admitted COVID-19 Patients-A Retrospective Single Institute Study

Paweł Radkowski, Bartosz Kędziora, Anna Witt-Majchrzak, Radoslaw Borysiuk, Justyna Dawidowska-Fidrych and Łukasz Grabarczyk

Background and Objective: The emergence of COVID-19 necessitated the establishment of dedicated treatment units globally. This study examines patient outcomes and risk factors in a cohort of COVID-19 patients at the Provincial Specialist Hospital in Olsztyn. Materials and Methods: Patients admitted to the COVID-19 Department of the Provincial Specialist Hospital in Olsztyn between November 28, 2021 and February 28, 2022, were retrospectively analysed. Data including age, gender, ASA classification, vaccination status and percentage of lung involvement by COVID-19 lesions were extracted from electronic medical records. Results: The overall mortality rate is 27%. Patients classified as ASA III had the highest mortality rate (36.5%), followed by those classified as ASA IV (55.6%). Multivariate analysis showed that patients over 80 years old had a 4.35 times higher risk of death than those under 60 years of age (aHR 4.35, 95% CI 1.13-16.61, p<0.05). Furthermore, for every 1% increase in lung involvement due to COVID-19 lesions, the mortality risk increased by 2% (aHR 1.02, 95% CI 1.01-1.03, p = 0.0001). Among hospitalized patients, 14% were fully vaccinated. This study found that unvaccinated individuals had a four-fold higher risk of death than fully vaccinated patients (OR 3.9, 95% CI 1.1-13.9, p<0.05). Additionally, Kaplan-Meier survival analysis showed that fully vaccinated patients had a 100% survival probability at 9 days, whereas unvaccinated individuals had a survival probability of only 78.6% (p<0.05). Conclusion: Age and percentage of lung involvement were significant predictors of mortality in COVID-19 patients, while ASA classification showed limited predictive value. Routine chest CT scans and vaccination status emerged as crucial determinants of patient outcomes, emphasizing the importance of comprehensive clinical assessments and vaccination strategies in managing COVID-19.

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