TY - JOUR
T1 - Factors Associated with All-Cause 30-Day Mortality in Indonesian Inpatient COVID-19 Patients at Cipto Mangunkusumo National General Hospital
AU - Rinaldi, Ikhwan
AU - Yulianti, Mira
AU - Yunihastuti, Evy
AU - Rajabto, Wulyo
AU - Irawan, Cosphiadi
AU - Sukrisman, Lugyanti
AU - Rachman, Andhika
AU - Mulansari, Nadia Ayu
AU - Lubis, Anna Mira
AU - Prasetyawaty, Findy
AU - Cahyanur, Rahmat
AU - Priantono, Dimas
AU - Ahani, Ardhi Rahman
AU - Muthalib, Abdul
AU - Sudoyo, Aru
AU - Atmakusuma, Tubagus Djumhana
AU - Reksodiputro, Arry Harryanto
AU - Djoerban, Zubairi
AU - Tambunan, Karmel
AU - Winston, Kevin
AU - Shufiyani, Yuli Maulidiya
AU - Wiyono, Lowilius
AU - Pratama, Samuel
AU - Edina, Brenda Cristie
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/5
Y1 - 2024/5
N2 - Introduction: Indonesia, as a developing country, has limited data on the factors associated with 30-day mortality in COVID-19 patients in Indonesia. As a matter of fact, study analyzing factors associated with 30-day mortality of COVID-19 infection in Indonesia has never been conducted. This study aims to fill this gap in the literature by conducting a large-scale analysis of factors associated with 30-day mortality in COVID-19 patients in Indonesia. Method: This study employed a single-center retrospective cohort observational design, and was conducted at Cipto Mangunkusumo National General Hospital between the years 2022 and 2023. Sampling was conducted using the consecutive sampling method. The study included patients aged 18 years and above who had been confirmed to have COVID-19 infection. Survival analysis was conducted using Kaplan–Meier and multivariate Cox regression analysis. Result: Our study included a total of 644 patients, with 120 patients (18.6%) expiring within 30 days. In the multivariate analysis using the backward Wald method, severe COVID-19 (HR: 7.024; 95% CI: 3.971–12.744; p value: <0.0001), moderate COVID-19 infection (HR: 1.660; 95% CI: 1.048–2.629; p value: 0.031), liver cirrhosis (HR: 3.422; 95% CI: 1.208–9.691; p value: 0.021), female sex (HR: 1.738; 95% CI: 1.187–2.545; p value: 0.004), old age (HR: 2.139; 95% CI: 1.279–3.577; p value: 0.004), high leukocyte (HR: 11.502; 95% CI: 1.523–86.874; p value: 0.018), high NLR (HR: 1.720; 95% CI: 1.049–2.819; p value: 0.032), high CRP (HR: 1.906; 95% CI: 1.092–3.329; p value: 0.023), high procalcitonin (HR: 3.281; 95% CI: 1.780–6.049; p value: 0.001), and high creatinine (HR: 1.863; 95% CI: 1.240–2.800; p value: 0.003) were associated with 30-day mortality from COVID-19 infection. Subgroup analysis excluding cancer patients showed that age, D-Dimer, CRP, and PCT were associated with 30-day mortality in COVID-19 patients, while steroid therapy is protective. Conclusions: This study finds that COVID-19 severity, liver cirrhosis, sex, age, leukocyte, NLR, CRP, creatinine, and procalcitonin were associated with COVID-19 mortality within 30 days. These findings underscore the multifactorial nature of COVID-19 infection mortality. It is important, therefore, that patients which exhibit these factors should be treated more aggressively to prevent mortality.
AB - Introduction: Indonesia, as a developing country, has limited data on the factors associated with 30-day mortality in COVID-19 patients in Indonesia. As a matter of fact, study analyzing factors associated with 30-day mortality of COVID-19 infection in Indonesia has never been conducted. This study aims to fill this gap in the literature by conducting a large-scale analysis of factors associated with 30-day mortality in COVID-19 patients in Indonesia. Method: This study employed a single-center retrospective cohort observational design, and was conducted at Cipto Mangunkusumo National General Hospital between the years 2022 and 2023. Sampling was conducted using the consecutive sampling method. The study included patients aged 18 years and above who had been confirmed to have COVID-19 infection. Survival analysis was conducted using Kaplan–Meier and multivariate Cox regression analysis. Result: Our study included a total of 644 patients, with 120 patients (18.6%) expiring within 30 days. In the multivariate analysis using the backward Wald method, severe COVID-19 (HR: 7.024; 95% CI: 3.971–12.744; p value: <0.0001), moderate COVID-19 infection (HR: 1.660; 95% CI: 1.048–2.629; p value: 0.031), liver cirrhosis (HR: 3.422; 95% CI: 1.208–9.691; p value: 0.021), female sex (HR: 1.738; 95% CI: 1.187–2.545; p value: 0.004), old age (HR: 2.139; 95% CI: 1.279–3.577; p value: 0.004), high leukocyte (HR: 11.502; 95% CI: 1.523–86.874; p value: 0.018), high NLR (HR: 1.720; 95% CI: 1.049–2.819; p value: 0.032), high CRP (HR: 1.906; 95% CI: 1.092–3.329; p value: 0.023), high procalcitonin (HR: 3.281; 95% CI: 1.780–6.049; p value: 0.001), and high creatinine (HR: 1.863; 95% CI: 1.240–2.800; p value: 0.003) were associated with 30-day mortality from COVID-19 infection. Subgroup analysis excluding cancer patients showed that age, D-Dimer, CRP, and PCT were associated with 30-day mortality in COVID-19 patients, while steroid therapy is protective. Conclusions: This study finds that COVID-19 severity, liver cirrhosis, sex, age, leukocyte, NLR, CRP, creatinine, and procalcitonin were associated with COVID-19 mortality within 30 days. These findings underscore the multifactorial nature of COVID-19 infection mortality. It is important, therefore, that patients which exhibit these factors should be treated more aggressively to prevent mortality.
KW - cancer
KW - COVID-19
KW - D-Dimer
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=85194244924&partnerID=8YFLogxK
U2 - 10.3390/jcm13102998
DO - 10.3390/jcm13102998
M3 - Article
AN - SCOPUS:85194244924
SN - 2077-0383
VL - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 10
M1 - 2998
ER -