J Korean Soc Emerg Med.  2022 Feb;33(1):94-105.

Mortality prognostic factors of COVID-19 in the emergency department during outbreak in Daegu, Korea: a multicenter retrospective study

• Kim Jy
• Kim JH
• Ryoo HW
• Ahn JY
• Moon S
• Lee DE
• Lee SH
• Mun YH
• Jang TC

Abstract

Objective
We aimed to investigate the characteristics and prognostic factors of coronavirus disease 2019 (COVID-19) patients in the emergency departments (EDs) in Daegu, Korea, the region with the second regional outbreak worldwide.
Methods
We conducted a retrospective observational multicenter study using a population-based COVID-19 registry of EDs. We included the demographic, clinical and laboratory data. Cox proportional hazard regression analysis was performed to identify the prognostic factors of mortality.
Results
A total of 241 patients were included in this study. In the Cox hazard regression model (hazard ratio [95% confidence interval]), age (65-79 years: 3.531 [1.529-8.156], ≥80 years: 5.335 [2.229-12.770]), respiratory rate (RR) (>20 breaths/min: 2.025 [1.205-3.403], ≤11 breaths/min: 111.292 [30.845-401.555]), lymphocyte counts <1.0×10⁹/L (2.611 [1.494-4.739]), blood urea nitrogen (BUN) levels>23 mg/dL (2.047 [1.233-3.399]), aspartate aminotransferase (AST) levels>40 IU/L (1.785 [1.009-3.158]) and neutrophil counts>6.3×10⁹/L (1.638 [1.014-2.644]) were associated with mortality.
Conclusion
Age, RR, lymphocyte counts, BUN levels, AST levels and neutrophil counts were prognostic factors in COVID-19 patients in the ED. These factors can help effectively treat and reduce mortality through optimized management of COVID-19 patients, in places with limited emergency medical resources such as massive regional outbreaks.

Keyword

Coronavirus; Disease outbreaks; Emergency treatment; Prognosis; Mortality