Risk Factors for In-Hospital Mortality among a Cohort of Children with Clostridium difficile Infection

2015 ◽  
Vol 36 (10) ◽  
pp. 1183-1189 ◽  
Author(s):  
Neika Vendetti ◽  
Theoklis Zaoutis ◽  
Susan E. Coffin ◽  
Julia Shaklee Sammons
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Hospital Mortality ◽  
Severe Disease ◽  
Treatment Strategies ◽  
Severity Of Illness ◽  
Median Number ◽  
Multivariable Logistic Regression Model ◽  
Risk Of Death ◽  
Increased Risk

OBJECTIVEThe incidence of Clostridium difficile infection (CDI) has increased and has been associated with poor outcomes among hospitalized children, including increased risk of death. The purpose of this study was to identify risk factors for all-cause in-hospital mortality among children with CDI.METHODSA multicenter cohort of children with CDI, aged 1–18 years, was established among children hospitalized at 41 freestanding children’s hospitals between January 1, 2006 and August 31, 2011. Children with CDI were identified using a validated case-finding tool (ICD-9-CM code for CDI plus C. difficile test charge). Only the first CDI-related hospitalization during the study period was used. Risk factors for all-cause in-hospital mortality within 30 days of C. difficile test were evaluated using a multivariable logistic regression model.RESULTSWe identified 7,318 children with CDI during the study period. The median age of this cohort was 6 years [interquartile range (IQR): 2–13]; the mortality rate was 1.5% (n=109); and the median number of days between C. difficile testing and death was 12 (IQR, 7–20). Independent risk factors for death included older age [adjusted odds ratio (OR, 95% confidence interval), 2.29 (1.40–3.77)], underlying malignancy [3.57 (2.36–5.40)], cardiovascular disease [2.06 (1.28–3.30)], hematologic/immunologic condition [1.89 (1.05–3.39)], gastric acid suppression [2.70 (1.43–5.08)], and presence of >1 severity of illness marker [3.88 (2.44–6.19)].CONCLUSIONPatients with select chronic conditions and more severe disease are at increased risk of death. Identifying risk factors for in-hospital mortality can help detect subpopulations of children that may benefit from targeted CDI prevention and treatment strategies.Infect Control Hosp Epidemiol 2015;36(10):1183–1189

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

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Karlijn van Halem ◽  
Robin Bruyndonckx ◽  
Jeroen van der Hilst ◽  
Janneke Cox ◽  
Paulien Driesen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Fatality Rate ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background 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. Methods 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. Results 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. Conclusions 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.

Association of dyspnea, mortality, and resource use in hospitalised patients

2021 ◽  
pp. 1902107
Author(s):  
Jennifer P. Stevens ◽  
Tenzin Dechen ◽  
Richard M. Schwartzstein ◽  
Carl O'Donnell ◽  
Kathy Baker ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Medical Center ◽  
Intensive Care Unit Discharge ◽  
Academic Medical Center ◽  
Severity Of Illness ◽  
Mortality And Morbidity ◽  
Risk Of Death ◽  
Hospitalised Patients ◽  
Increased Risk

As many as 1 in 10 patients experience dyspnea at hospital admission but the relationship between dyspnea and patient outcomes is unknown. We sought to determine whether dyspnea on admission predicts outcomes.We conducted a retrospective cohort study in a single, academic medical center. We analysed 67 362 consecutive hospital admissions with available data on dyspnea, pain, and outcomes. As part of the Initial Patient Assessment by nurses, patients rated “breathing discomfort” using a 0 to 10 scale, (10=“unbearable”). Patients reported dyspnea at the time of admission and recalled dyspnea experienced in the 24 h prior to admission. Outcomes included in-hospital mortality, 2-year mortality, length of stay, need for rapid response system activation, transfer to the intensive care unit, discharge to extended care, and 7- and 30-day all cause readmission to the same institution.Patients who reported any dyspnea were at an increased risk of death during that hospital stay; the greater the dyspnea, the greater the risk of death (dyspnea=0, 0.8% in-hospital mortality; dyspnea=1–3, 2.5% mortality; dyspnea ≥4, 3.7% mortality, p<0.001). After adjustment for patient comorbidities, demographics, and severity of illness, increasing dyspnea remained associated with inpatient mortality (dyspnea 1–3, aOR 2.1, 95% CI 1.7–2.6; dyspnea ≥4, aOR 3.1, 95% CI 2.4–3.9). Pain did not predict increased mortality. Patients reporting dyspnea also used more hospital resources, were more likely to be readmitted, and were at increased risk of death within 2 years (dyspnea=1–3 adjusted HR 1.5, 95% CI 1.3–1.6; dyspnea ≥4 adjusted HR 1.7, 95% CI 1.5–1.8).We found that dyspnea of any rating was associated with an increased risk of death. Dyspnea can be rapidly collected by nursing staff, which may allow for better monitoring or interventions that could reduce mortality and morbidity.

scholarly journals Risk Factors for Mortality and Progression to Severe COVID-19 Disease in the Southeast United States (US): A Report from the SEUS Study Group

2021 ◽  
pp. 1-33 ◽  
Author(s):  
Athena L. V. Hobbs ◽  
Nicholas Turner ◽  
Imad Omer ◽  
Morgan K. Walker ◽  
Ronald M. Beaulieu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mechanical Ventilation ◽  
Multivariate Analysis ◽  
Hospital Mortality ◽  
Mortality Risk ◽  
Severe Disease ◽  
Increased Risk ◽  
Male Sex ◽  
Southeast Us

Abstract Objective Identify risk factors that could increase progression to severe disease and mortality in hospitalized SARS-CoV-2 patients in the Southeast US. Design, Setting, and Participants Multicenter, retrospective cohort including 502 adults hospitalized with laboratory-confirmed COVID-19 between March 1, 2020 and May 8, 2020 within one of 15 participating hospitals in 5 health systems across 5 states in the Southeast US. Methods The study objectives were to identify risk factors that could increase progression to hospital mortality and severe disease (defined as a composite of intensive care unit admission or requirement of mechanical ventilation) in hospitalized SARS-CoV-2 patients in the Southeast US. Results A total of 502 patients were included, and the majority (476/502, 95%) had clinically evaluable outcomes. Hospital mortality was 16% (76/476), while 35% (177/502) required ICU admission, and 18% (91/502) required mechanical ventilation. By both univariate and adjusted multivariate analysis, hospital mortality was independently associated with age (adjusted odds ratio [aOR] 2.03 for each decade increase, 95% CI 1.56-2.69), male sex (aOR 2.44, 95% CI: 1.34-4.59), and cardiovascular disease (aOR 2.16, 95% CI: 1.15-4.09). As with mortality, risk of severe disease was independently associated with age (aOR 1.17 for each decade increase, 95% CI: 1.00-1.37), male sex (aOR 2.34, 95% CI 1.54-3.60), and cardiovascular disease (aOR 1.77, 95% CI 1.09-2.85). Conclusions In an adjusted multivariate analysis, advanced age, male sex, and cardiovascular disease increased risk of severe disease and mortality in patients with COVID-19 in the Southeast US. In-hospital mortality risk doubled with each subsequent decade of life.

scholarly journals Clinical Characteristics and Risk Factors for Fatality and Severity in Patients with Coronavirus Disease in Korea: A Nationwide Population-Based Retrospective Study Using the Korean Health Insurance Review and Assessment Service (HIRA) Database

2020 ◽  
Vol 17 (22) ◽  
pp. 8559
Author(s):  
Seung-Geun Lee ◽  
Geun U. Park ◽  
Yeo Rae Moon ◽  
Kihoon Sung
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Previous History ◽  
Population Based ◽  
Therapeutic Modalities ◽  
Risk Of Death ◽  
Increased Risk

Background: We aimed to investigate the clinical characteristics and risk factors for fatality and severity in these patients. Methods: In this nationwide population-based retrospective study, we investigated the data of 7339 laboratory-confirmed COVID-19 patients, aged ≥ 18 years, using the Korean Health Insurance Review and Assessment Service (HIRA) database. Comorbidities and medications used were identified using HIRA codes, and severe COVID-19 was defined as that requiring oxygen therapy, mechanical ventilator, cardiopulmonary resuscitation, or extracorporeal membrane oxygenation. The outcomes were death due to COVID-19 and COVID-19 severity. Results: Mean patient age was 47.1 years; 2970 (40.1%) patients were male. Lopinavir/ritonavir, hydroxychloroquine, antibiotics, ribavirin, oseltamivir, and interferon were administered to 35.8%, 28.4%, 38.1%, 0.1%, 0.3%, and 0.9% of patients, respectively. After adjusting for confounding factors, diabetes mellitus, chronic kidney disease, previous history of pneumonia, aging, and male were significantly associated with increased risk of death and severe disease. No medication was associated with a reduced risk of fatality and disease severity. Conclusions: We found several risk factors for fatality and severity in COVID-19 patients. As the drugs currently used for COVID-19 treatment have not shown significant efficacy, all efforts should be made to develop effective therapeutic modalities for COVID-19.

scholarly journals N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort

2021 ◽  
Author(s):  
Christian O’Donnell ◽  
Melanie D. Ashland ◽  
Elena C. Vasti ◽  
Ying Lu ◽  
Andrew Y. Chang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Hospital Mortality ◽  
Cardiovascular Risk Factors ◽  
Natriuretic Peptide ◽  
Fold Increase ◽  
Cardiac Events ◽  
Risk Of Death ◽  
Increased Risk

Background Currently, there is limited research on the prognostic value of NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) as a biomarker in COVID‐19. We proposed the a priori hypothesis that an elevated NT‐proBNP concentration at admission is associated with increased in‐hospital mortality. Methods and Results In this prospective, observational cohort study of the American Heart Association’s COVID‐19 Cardiovascular Disease Registry, 4675 patients hospitalized with COVID‐19 were divided into normal and elevated NT‐proBNP cohorts by standard age‐adjusted heart failure thresholds, as well as separated by quintiles. Patients with elevated NT‐proBNP (n=1344; 28.7%) were older, with more cardiovascular risk factors, and had a significantly higher rate of in‐hospital mortality (37% versus 16%; P <0.001) and shorter median time to death (7 versus 9 days; P <0.001) than those with normal values. Analysis by quintile of NT‐proBNP revealed a steep graded relationship with mortality (7.1%–40.2%; P <0.001). NT‐proBNP was also associated with major adverse cardiac events, intensive care unit admission, intubation, shock, and cardiac arrest ( P <0.001 for each). In subgroup analyses, NT‐proBNP, but not prior heart failure, was associated with increased risk of in‐hospital mortality. Adjusting for cardiovascular risk factors with presenting vital signs, an elevated NT‐proBNP was associated with 2‐fold higher adjusted odds of death (adjusted odds ratio [OR], 2.23; 95% CI, 1.80–2.76), and the log‐transformed NT‐proBNP with other biomarkers projected a 21% increased risk of death for each 2‐fold increase (adjusted OR, 1.21; 95% CI, 1.08–1.34). Conclusions Elevated NT‐proBNP levels on admission for COVID‐19 are associated with an increased risk of in‐hospital mortality and other complications in patients with and without heart failure.

scholarly journals Risk factors for in-hospital mortality in laboratory-confirmed COVID-19 patients in the Netherlands: A competing risk survival analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249231
Author(s):  
Gerine Nijman ◽  
Maike Wientjes ◽  
Jordache Ramjith ◽  
Nico Janssen ◽  
Jacobien Hoogerwerf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Survival Analysis ◽  
The Netherlands ◽  
Hospital Mortality ◽  
Survival Data ◽  
Competing Risk ◽  
Early Warning Score ◽  
Risk Of Death ◽  
Antiplatelet Medication ◽  
Increased Risk

Background To date, survival data on risk factors for COVID-19 mortality in western Europe is limited, and none of the published survival studies have used a competing risk approach. This study aims to identify risk factors for in-hospital mortality in COVID-19 patients in the Netherlands, considering recovery as a competing risk. Methods In this observational multicenter cohort study we included adults with PCR-confirmed SARS-CoV-2 infection that were admitted to one of five hospitals in the Netherlands (March to May 2020). We performed a competing risk survival analysis, presenting cause-specific hazard ratios (HRCS) for the effect of preselected factors on the absolute risk of death and recovery. Results 1,006 patients were included (63.9% male; median age 69 years, IQR: 58–77). Patients were hospitalized for a median duration of 6 days (IQR: 3–13); 243 (24.6%) of them died, 689 (69.9%) recovered, and 74 (7.4%) were censored. Patients with higher age (HRCS 1.10, 95% CI 1.08–1.12), immunocompromised state (HRCS 1.46, 95% CI 1.08–1.98), who used anticoagulants or antiplatelet medication (HRCS 1.38, 95% CI 1.01–1.88), with higher modified early warning score (MEWS) (HRCS 1.09, 95% CI 1.01–1.18), and higher blood LDH at time of admission (HRCS 6.68, 95% CI 1.95–22.8) had increased risk of death, whereas fever (HRCS 0.70, 95% CI 0.52–0.95) decreased risk of death. We found no increased mortality risk in male patients, high BMI or diabetes. Conclusion Our competing risk survival analysis confirms specific risk factors for COVID-19 mortality in a the Netherlands, which can be used for prediction research, more intense in-hospital monitoring or prioritizing particular patients for new treatments or vaccination.

scholarly journals Proton pump inhibitors versus histamine-2 receptor blockers for stress ulcer prophylaxis in patients with sepsis: a retrospective cohort study

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110251
Author(s):  
Minqiang Huang ◽  
Ming Han ◽  
Wei Han ◽  
Lei Kuang
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Proton Pump ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Stress Ulcer ◽  
Increased Risk ◽  
Ulcer Prophylaxis

Objective We aimed to compare the efficacy and risks of proton pump inhibitor (PPI) versus histamine-2 receptor blocker (H2B) use for stress ulcer prophylaxis (SUP) in critically ill patients with sepsis and risk factors for gastrointestinal bleeding (GIB). Methods In this retrospective cohort study, we used the Medical Information Mart for Intensive Care III Clinical Database to identify critically ill adult patients with sepsis who had at least one risk factor for GIB and received either an H2B or PPI for ≥48 hours. Propensity score matching (PSM) was conducted to balance baseline characteristics. The primary outcome was in-hospital mortality. Results After 1:1 PSM, 1056 patients were included in the H2B and PPI groups. The PPI group had higher in-hospital mortality (23.8% vs. 17.5%), GIB (8.9% vs. 1.6%), and pneumonia (49.6% vs. 41.6%) rates than the H2B group. After adjusting for risk factors of GIB and pneumonia, PPI use was associated with a 1.28-times increased risk of in-hospital mortality, 5.89-times increased risk of GIB, and 1.32-times increased risk of pneumonia. Conclusions Among critically ill adult patients with sepsis at risk for GIB, SUP with PPIs was associated with higher in-hospital mortality and higher risk of GIB and pneumonia than H2Bs.

scholarly journals Mortality and high risk of major adverse events in patients with COVID-19 and history of cardiovascular disease

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001526
Author(s):  
Elena Tessitore ◽  
David Carballo ◽  
Antoine Poncet ◽  
Nils Perrin ◽  
Cedric Follonier ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Male Gender ◽  
Hospital Death ◽  
Chronic Obstructive ◽  
University Hospitals ◽  
Adverse Cardiovascular Event ◽  
Risk Of Death ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
History Of

ObjectiveHistory of cardiovascular diseases (CVDs) may influence the prognosis of patients hospitalised for COVID-19. We investigated whether patients with previous CVD have increased risk of death and major adverse cardiovascular event (MACE) when hospitalised for COVID-19.MethodsWe included 839 patients with COVID-19 hospitalised at the University Hospitals of Geneva. Demographic characteristics, medical history, laboratory values, ECG at admission and medications at admission were collected based on electronic medical records. The primary outcome was a composite of in-hospital mortality or MACE.ResultsMedian age was 67 years, 453 (54%) were males and 277 (33%) had history of CVD. In total, 152 (18%) died and 687 (82%) were discharged, including 72 (9%) who survived a MACE. Patients with previous CVD were more at risk of composite outcomes 141/277 (51%) compared with those without CVD 83/562 (15%) (OR=6.0 (95% CI 4.3 to 8.4), p<0.001). Multivariate analyses showed that history of CVD remained an independent risk factor of in-hospital death or MACE (OR=2.4; (95% CI 1.6 to 3.5)), as did age (OR for a 10-year increase=2.2 (95% CI 1.9 to 2.6)), male gender (OR=1.6 (95% CI 1.1 to 2.3)), chronic obstructive pulmonary disease (OR=2.1 (95% CI 1.0 to 4.2)) and lung infiltration associated with COVID-19 at CT scan (OR=1.9 (95% CI 1.2 to 3.0)). History of CVD (OR=2.9 (95% CI 1.7 to 5)), age (OR=2.5 (95% CI 2.0 to 3.2)), male gender (OR=1.6 (95% CI 0.98 to 2.6)) and elevated C reactive protein (CRP) levels on admission (OR for a 10 mg/L increase=1.1 (95% CI 1.1 to 1.2)) were independent risk factors for mortality.ConclusionHistory of CVD is associated with higher in-hospital mortality and MACE in hospitalised patients with COVID-19. Other factors associated with higher in-hospital mortality are older age, male sex and elevated CRP on admission.

scholarly journals Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Melissa Bauserman ◽  
Vanessa R. Thorsten ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Maternal Deaths ◽  
Middle Income ◽  
Maternal Risk ◽  
Live Births ◽  
Middle Income Countries ◽  
Risk Of Death ◽  
Increased Risk ◽  
Over Time

Abstract Background Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time. Methods We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time. Results We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites. Conclusions The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030. Trial registration The MNHR is registered at NCT01073475.

scholarly journals Baseline T-lymphocyte subset absolute counts can predict both outcome and severity in SARS-CoV-2 infected patients: a single center study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marco Iannetta ◽  
Francesco Buccisano ◽  
Daniela Fraboni ◽  
Vincenzo Malagnino ◽  
Laura Campogiani ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
T Lymphocyte ◽  
Lymphocyte Subsets ◽  
Severe Disease ◽  
Laboratory Data ◽  
Lymphocyte Subset ◽  
Multivariable Logistic Regression Analysis ◽  
Double Positive ◽  
Increased Risk ◽  
T Lymphocyte Subset

AbstractThe aim of this study was to evaluate the role of baseline lymphocyte subset counts in predicting the outcome and severity of COVID-19 patients. Hospitalized patients confirmed to be infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) were included and classified according to in-hospital mortality (survivors/nonsurvivors) and the maximal oxygen support/ventilation supply required (nonsevere/severe). Demographics, clinical and laboratory data, and peripheral blood lymphocyte subsets were retrospectively analyzed. Overall, 160 patients were retrospectively included in the study. T-lymphocyte subset (total CD3+, CD3+ CD4+, CD3+ CD8+, CD3+ CD4+ CD8+ double positive [DP] and CD3+ CD4− CD8− double negative [DN]) absolute counts were decreased in nonsurvivors and in patients with severe disease compared to survivors and nonsevere patients (p < 0.001). Multivariable logistic regression analysis showed that absolute counts of CD3+ T-lymphocytes < 524 cells/µl, CD3+ CD4+ < 369 cells/µl, and the number of T-lymphocyte subsets below the cutoff (T-lymphocyte subset index [TLSI]) were independent predictors of in-hospital mortality. Baseline T-lymphocyte subset counts and TLSI were also predictive of disease severity (CD3+  < 733 cells/µl; CD3+ CD4+ < 426 cells/µl; CD3+ CD8+ < 262 cells/µl; CD3+ DP < 4.5 cells/µl; CD3+ DN < 18.5 cells/µl). The evaluation of peripheral T-lymphocyte absolute counts in the early stages of COVID-19 might represent a useful tool for identifying patients at increased risk of unfavorable outcomes.

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