# Predictors of Impaired Treatment Outcomes in COVID-19: A Single-Center Observational Study from Serbia

## TL;DR

This study identifies factors like age, CRP levels, ICU hospitalization, and pulmonary embolism that predict worse outcomes in COVID-19 patients.

## Contribution

The study identifies new independent predictors of impaired outcomes in COVID-19 patients, including pulmonary embolism and CRP levels.

## Key findings

- Older age, elevated CRP levels, ICU hospitalization, and pulmonary embolism are significant predictors of poor outcomes in COVID-19 patients.
- Patients with pulmonary embolism had higher mortality and mechanical ventilation rates.
- Invasive mechanical ventilation was strongly associated with impaired treatment outcomes.

## Abstract

Background: COVID-19 disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); it is characterized by a hypercoagulable state that results in an increased risk for embolic and thrombotic vascular complications. The incidence of pulmonary embolism (PE) in COVID-19 varies between 20 and 30%. In addition to PE, older age, male sex, the presence of comorbidities, invasive mechanical ventilation, and prolonged hospitalization in intensive care units (ICUs) seem to be the main predictors for impaired treatment outcomes in COVID-19. Materials and methods: A retrospective observational single-center study was conducted between 1 September 2021 and 24 December 2021 involving 2111 patients admitted to the COVID Hospital “Batajnica”, University Clinical Center of Serbia, Belgrade. A total of 200 consecutive patients were enrolled in study. Patients were divided into two groups—the study group (100 patients), with COVID-19 and PE, and the control group (100 patients), with COVID-19 but without PE. Results: According to the multivariate regression analysis, the predictors of impaired outcomes in COVID-19 patients are age (p < 0.001; OR 1.134; 95% HR 1.062–1.211), C reactive protein level (CRP) (p = 0.043; OR 1.006; 95% 1.000–1.013), invasive mechanical ventilation (IMV) (p < 0.001; OR 58.72; 95% HR 13.784–254.189), pulmonary embolism (PE) (p = 0.025; OR 3.718; 95% HR 1.183–11.681), and hospitalization in ICU (p = 0.012; OR 9.673; 95% 1.660–56.363). Conclusions: We report increased mortality and mechanical ventilation rates in COVID-19 patients with acute PE. Older age, elevated levels of CRP, hospitalization in ICU, and PE present independent predictors for impaired outcomes in COVID-19 patients. To determine predictors for treatment outcomes in patients with COVID-19 and their associations with clinical and laboratory parameters