In March 2020, 25% of patients with COVID-19 were admitted to the intensive care unit (ICU) and 19% died.
The main clinical factors associated with death were age and neurological or renal disease.
The main biological factors associated with death were high CRP and creatinine levels, and low hemoglobin levels.
The main complications were kidney and liver failure, cardiac and thromboembolism events.
Most extrapulmonary complications occurred in ICU patients.
A major coronavirus disease 2019 (COVID-19) outbreak occurred in Northeastern France in spring 2020. This single-center retrospective observational cohort study aimed to compare patients with severe COVID-19 and those with non-severe COVID-19 (survivors vs. non-survivors, ICU patients vs. non-ICU patients) and to describe extrapulmonary complications.
Patients and methods
We included all patients with a confirmed diagnosis of COVID-19 admitted to Colmar Hospital in March 2020.
We examined 600 patients (median age 71.09 years; median body mass index: 26.9 kg/m2); 57.7% were males, 86.3% had at least one comorbidity, 153 (25.5%) required ICU hospitalization, and 115 (19.1%) died. Baseline independent factors associated with death were older age (>75 vs. ≤75 years), male sex, oxygen supply, chronic neurological, renal, and pulmonary diseases, diabetes, cancer, low platelet and hemoglobin counts, and high levels of C-reactive protein (CRP) and serum creatinine. Factors associated with ICU hospitalization were age <75 years, oxygen supply, chronic pulmonary disease, absence of dementia, and high levels of CRP, hemoglobin, and serum creatinine. Among the 600 patients, 80 (13.3%) had an acute renal injury, 33 (5.5%) had a cardiovascular event, 27 (4.5%) had an acute liver injury, 24 (4%) had venous thromboembolism, eight (1.3%) had a neurological event, five (0.8%) had rhabdomyolysis, and one had acute pancreatitis. Most extrapulmonary complications occurred in ICU patients.
This study highlighted the main risk factors for ICU hospitalization and death caused by severe COVID-19 and the frequency of numerous extrapulmonary complications in France.Le texte complet de cet article est disponible en PDF.
Keywords : COVID-19, SARS-CoV-2, Outcome, Extrapulmonary COVID-19, Mortality