Keywords: mortality Covid-19

Background:

In Bulgaria, statistical data documented a mortality rate of 369 per 100 000 of the population, ranking second worldwide and first in Europe.

Research questions:

The objective was to outline the specifics of the Bulgarian patients with Covid-19, alongside with the most important mortality predictors.

Method:

The study was retrospective, observational and included 306 hospitalized patients, with a positive PCR test. They were assigned into three severity groups: moderate, severe and critical. Demographic, clinical, laboratory and imaging parameters were assessed. Parametrical and non – parametrical analysis was used for statistics.

Results:

Results showed that unlike data from most European countries, in Bulgaria, demographic factors did not impact mortality. – patients aged < 65 had a lower mortality rate compared to those > 65 but the difference was not statistically significant (p= 0.125). Patients’ sex, place of residence, smoking status and living in a nursing care facility did not affect mortality rates significantly (p=0.457, p= 0.680, p=0.234, p= 0.259 resp.). Patients with cough and breathlessness had worse outcomes compared to those without – p=0.029 and p= 0.002 resp.). Laboratory parameters indicating high risk of lethal outcome were: elevated serum d- dimers, creatinine and ferritin: p= 0.0015, p= 0.038 and p=0.009 resp.). Hypoxemia on ABG also had a negative impact on survival – p= 0.006 and p= 0.021 resp. Moreover, patient with normal chest X rays on admission had a good disease outcome, compared with those with signs of pneumonia, the difference being statistically significant – p= 0.031. In terms of comorbidities, patients without pre-existing disorders had better survival rates compared to those with comorbidities – p=0.031). Among comorbidities – chronic cardiovascular and pulmonary disorders as well as diabetes adversely affected the outcome of Covid-19 – p= 0.003, p=0.003 and p= 0.017 resp. ).

Conclusions:

Knowledge of and early stratification of patients will positively influence the outcome.

Points for discussion:

lack of age difference in the mortalit rates in Bulgaria

lack of male predominance