Clinical features and major bleeding predictors for 161 fatal cases of  COVID-19: A retrospective observational study

Gokhan Alici; Hasan Ali Barman; Ramazan Asoglu; Adem Atici; Atike Nazli Akciger; Omer  Sit; Omer Dogan; Yucel Yavuz; Songul  Borahan; Omer Genc; Baris Gungor

doi:10.17305/bjbms.2021.6577

Authors

Gokhan Alici Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey https://orcid.org/0000-0002-4589-7566
Hasan Ali Barman Istanbul University – Cerrahpaşa, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
Ramazan Asoglu Adiyaman Training ve Research Hospital, Department of Cardiology, Adiyaman, Turkey https://orcid.org/0000-0002-4777-1166
Adem Atici Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
Atike Nazli Akciger University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey https://orcid.org/0000-0002-2261-1457
Omer Sit University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
Omer Dogan Istanbul University – Cerrahpaşa, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey https://orcid.org/0000-0003-2279-6110
Yucel Yavuz University of Health Sciences, Okmeydani Training and Research Hospital, Department of Anesthesiology and Intensive Care, Istanbul, Turkey
Songul Borahan University of Health Sciences, Okmeydani Training and Research Hospital, Department of Anesthesiology and Intensive Care, Istanbul, Turkey
Omer Genc Agri Training ve Research Hospital, Department of Cardiology, Agri, Turkey https://orcid.org/0000-0002-9097-5391
Baris Gungor University of Health Sciences, Dr. Siyami Ersek Training and Research Hospital, Department of Cardiology, Istanbul, Turkey https://orcid.org/0000-0002-8883-117X

DOI:

https://doi.org/10.17305/bjbms.2021.6577

Keywords:

Major bleeding, COVID-19, mortality, acute respiratory distress syndrome, cardiac injury

Abstract

The aim of this study was to investigate the patient characteristics and laboratory parameters for COVID-19 non-survivors as well as to find risk factors for major bleeding complications. For this retrospective study, the data of patients who died with COVID-19 in our intensive care unit were collected in the period of March 20 - April 30, 2020. D-dimer, platelet count, C-reactive protein (CRP), troponin, and international normalized ratio (INR) levels were recorded on the 1st, 5th, and 10th days of hospitalization in order to investigate the possible correlation of laboratory parameter changes with in-hospital events. A total of 161 non-survivors patients with COVID-19 were included in the study. The median age was 69.8±10.9 years, and 95 (59%) of the population were male. Lung-related complications were the most common in-hospital complications. Patients with COVID-19 had in-hospital complications such as major bleeding (39%), hemoptysis (14%), disseminated intravascular coagulation (13%), liver failure (21%), ARDS (85%), acute kidney injury (40%), and myocardial injury (70%). A multiple logistics regression analysis determined that age, hypertension, diabetes mellitus, use of acetylsalicylic acid (ASA) or low molecular weight heparin (LMWH), hemoglobin, D-dimer, INR, and acute kidney injury were independent predictors of major bleeding. Our results showed that a high proportion of COVID-19 non-survivors suffered from major bleeding complications.