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

Abstract

The aim of this study was to investigate the patient characteristics and laboratory parameters for coronavirus disease-2019 (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 of COVID-19 in our intensive care unit were collected in the period of March 20, 2020-April 30, 2020. D-dimer, platelet count, C-reactive protein (CRP), high-sensitivity Troponin I (hs-TnI), and international normalized ratio (INR) levels were recorded on the 1st, 5th, and 10th days of hospitalization 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 (DEC) (13%), liver failure (21%), acute respiratory distress syndrome (ARDS) (85%), acute kidney injury (AKI) (40%), and myocardial injury (70%). A multiple logistics regression analysis determined that age, hypertension (HT), diabetes mellitus (DM), use of acetylsalicylic acid or low-molecular-weight heparin (LMWH), hemoglobin, D-dimer, INR, and AKI were independent predictors of major bleeding. Our results showed that a high proportion of COVID-19 non-survivors suffered from major bleeding complications.