Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study

{ 'DOI': '10.1186/s12879-020-05605-3', 'ISSN': ['1471-2334'], 'URL': 'http://dx.doi.org/10.1186/s12879-020-05605-3', 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>Belgium was among the first countries in Europe with confirmed ' 'coronavirus disease 2019 (COVID-19) 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.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>This study describes the clinical characteristics, complications and ' 'outcomes of 319 hospitalized COVID-19 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 ' 'analysis.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>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.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusions</jats:title>\n' ' <jats:p>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 measures.</jats:p>\n' ' </jats:sec>', 'alternative-id': ['5605'], 'article-number': '897', 'assertion': [ { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Received', 'name': 'received', 'order': 1, 'value': '8 June 2020'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Accepted', 'name': 'accepted', 'order': 2, 'value': '9 November 2020'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'First Online', 'name': 'first_online', 'order': 3, 'value': '27 November 2020'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Change Date', 'name': 'change_date', 'order': 4, 'value': '14 December 2020'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Change Type', 'name': 'change_type', 'order': 5, 'value': 'Correction'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Change Details', 'name': 'change_details', 'order': 6, 'value': 'An amendment to this paper has been published and can be accessed via the ' 'original article.'}, { 'group': {'label': 'Ethics approval and consent to participate', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 1, 'value': 'The study was approved by the Ethics Committee of Jessa Hospital, Hasselt, ' 'Belgium (ethical approval number 20.38-infect20.06). The requirement for ' 'informed consent was waived because of the retrospective nature of the study.'}, { 'group': {'label': 'Consent for publication', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 2, 'value': 'Not applicable.'}, { 'group': {'label': 'Competing interests', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 3, 'value': 'The authors declare that they have no competing interests.'}], 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-9483-8522', 'affiliation': [], 'authenticated-orcid': False, 'family': 'van Halem', 'given': 'Karlijn', 'sequence': 'first'}, {'affiliation': [], 'family': 'Bruyndonckx', 'given': 'Robin', 'sequence': 'additional'}, {'affiliation': [], 'family': 'van der Hilst', 'given': 'Jeroen', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Cox', 'given': 'Janneke', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Driesen', 'given': 'Paulien', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Opsomer', 'given': 'Matthias', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Van Steenkiste', 'given': 'Eveline', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Stessel', 'given': 'Björn', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Dubois', 'given': 'Jasperina', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Messiaen', 'given': 'Peter', 'sequence': 'additional'}], 'container-title': 'BMC Infectious Diseases', 'container-title-short': 'BMC Infect Dis', 'content-domain': {'crossmark-restriction': False, 'domain': ['link.springer.com']}, 'created': { 'date-parts': [[2020, 11, 27]], 'date-time': '2020-11-27T10:02:45Z', 'timestamp': 1606471365000}, 'deposited': { 'date-parts': [[2020, 12, 14]], 'date-time': '2020-12-14T12:14:32Z', 'timestamp': 1607948072000}, 'indexed': {'date-parts': [[2024, 3, 19]], 'date-time': '2024-03-19T11:02:51Z', 'timestamp': 1710846171007}, 'is-referenced-by-count': 32, 'issue': '1', 'issued': {'date-parts': [[2020, 11, 27]]}, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2020, 12]]}}, 'language': 'en', 'license': [ { 'URL': 'http://creativecommons.org/licenses/by/4.0/', 'content-version': 'tdm', 'delay-in-days': 0, 'start': { 'date-parts': [[2020, 11, 27]], 'date-time': '2020-11-27T00:00:00Z', 'timestamp': 1606435200000}}, { 'URL': 'http://creativecommons.org/licenses/by/4.0/', 'content-version': 'vor', 'delay-in-days': 0, 'start': { 'date-parts': [[2020, 11, 27]], 'date-time': '2020-11-27T00:00:00Z', 'timestamp': 1606435200000}}], 'link': [ { 'URL': 'http://link.springer.com/content/pdf/10.1186/s12879-020-05605-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://link.springer.com/article/10.1186/s12879-020-05605-3/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://link.springer.com/content/pdf/10.1186/s12879-020-05605-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '297', 'original-title': [], 'prefix': '10.1186', 'published': {'date-parts': [[2020, 11, 27]]}, 'published-online': {'date-parts': [[2020, 11, 27]]}, 'published-print': {'date-parts': [[2020, 12]]}, 'publisher': 'Springer Science and Business Media LLC', 'reference': [ { 'key': '5605_CR1', 'unstructured': 'World Health Organization. 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