Retrospective Study
Copyright ©The Author(s) 2021.
World J Clin Cases. Oct 6, 2021; 9(28): 8374-8387
Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8374
Table 1 Overall baseline characteristics of the study population
African Americans, n (%)
European- Americans, n (%)
Latin-Americans, n (%)
Indices
Discharge status (n = 385)
Alive (n = 322)204 (79.4)23 (88.5)95 (93.1)
Dead (n = 63)53 (20.6)3 (11.5)7 (6.9)
Sex (n = 386)
Female (n = 191)117 (45.5)11 (42.3)63 (61.2)
Male (n = 195)140 (54.5)15 (57.7)40 (38.8)
BMI (n = 332)
Normal (n = 127)75 (31.9)12 (52.2)40 (54.1)
Overweight (n = 94) 69 (29.4)6 (26.1)19 (25.7)
Obese (n = 111)91 (38.7)5 (21.7)15 (20.3)
Baseline comorbidities
Cardiac disease (n = 377)
No (n = 236)141 (55.3)18 (72)77 (79.4)
Yes (n = 141)114 (44.7)7 (28)20 (20.6)
Hypertension (n = 373)
No (n = 183)105 (41.7)10 (40)68 (70.8)
Yes (n = 190)147 (58.3)15 (60)28 (29.2)
Immunosuppression (n = 369)
No (n = 335)225 (88.9)21 (87.5)89 (96.7)
Yes (n = 34)28 (11.1)3 (12.5)3 (3.3)
Presenting symptoms
Fever (n = 383)
No (n = 174)107 (41.8)12 (46.2)55 (54.5)
Yes (n = 209)149 (58.2)14 (53.8)46 (45.5)
Cough (n = 380)
No (n = 151)93 (36.8)6 (23.1)52 (51.5)
Yes (n = 229)160 (63.2)20 (76.9)49 (48.5)
Shortness of breath (n = 381)
No (n = 144)85 (33.2)9 (36)50 (50)
Yes (n = 237)171 (66.8)16 (64)50 (50)
Fatigue (n = 236)
No (n = 143)78 (53.8)11 (55)54 (76.1)
Yes (n = 93)67 (46.2)9 (45)17 (23.9)
Nausea (n = 362)
No (n = 315)208 (86.7)19 (82.6)88 (88.9)
Yes (n = 47)32 (13.3)4 (17.4)11 (11.1)
Vomiting (n = 375)
No (n = 332)216 (87.1)22 (88)94 (92.2)
Yes (n = 43)32 (12.9)3 (12)8 (7.8)
Abdominal pain (n = 343)
No (n = 296)205 (87.6)17 (81)74 (84.1)
Yes (n = 47)29 (12.4)4 (19)14 (15.9)
Diarrhea (n = 377)
No (n = 317)203 (81.2)22 (88)92 (90.2)
Yes (n = 60)47 (18.8)3 (12)10 (9.8)
Anorexia (n = 325)
No (n = 238)147 (68.7)16 (80)75 (82.4)
Yes (n = 87)67 (31.3)4 (20)16 (17.6)
Laboratory results
Lymphocyte count (n = 380)
Normal (n = 193)120 (47,1)14 (53.8)59 (59.6)
Low (n = 163)120 (47.1)10 (38.5)33 (33.3)
Elevated (n = 24)15 (5.9)2 (7.7)7 (7.1)
CPK (n = 293)
Normal (n = 99)69 (32.5)7 (38.9)23 (36.5)
Elevated (n = 194)143 (67.5)11 (61.1)40 (63.5)
D-Dimer (n = 309)
Normal (n = 39)23 (10)6 (30)10 (17.2)
Elevated (n = 270)208 (90)14 (70)48 (82.8)
Procalcitonin (n = 276)
Normal (n = 163)114 (55.9)13 (72.2)36 (66.7)
Elevated (n = 113)90 (44.1)5 (27.8)18 (33.3)
Ferritin (n = 273)
Normal (n = 98)73 (35.4)5 (41.7)20 (36.4)
Elevated (n = 175)133 (64.6)7 (583)35 (63.6)
AST (n = 332)
Normal (n = 185)129 (54.7)13 (54.2)43 (59.7)
Elevated (n = 147)107 (45.3)11 (45.8)29 (40.3)
ALT (n = 329)
Normal (n = 231)168 (72.1)16 (66.7)47 (65.3)
Elevated (n = 98)65 (27.9)8 (33.3)25 (34.7)
ALP (n = 317)
Normal (n = 260)191 (86)17 (81)52 (70.3)
Elevated (n = 57)31 (14)4 (19)22 (29.7)
Hydroxychloroquine (n = 371)
No (n = 291)185 (92.4)24 (96)82 (88.2)
Yes (n = 80)68 (26.9)1 (04)11 (11.8)
Interventions
Glucocorticoids (n = 371)
No (n = 303)202 (73.1)20 (80)81 (87.1)
Yes (n = 68)51 (20.2)5 (20)23 (12.9)
Mechanical ventilation (n = 376)
No (n = 320)204 (81.3)23 (92)93 (93)
Yes (n = 56)47 (18.7)2 (8)7 (7)
BMI: Body mass index.
Table 2 Association between clinical laboratory markers and death as an outcome
Alive, n (%)
Dead, n (%)
OR1 (95%CI)
OR2 (95%CI)
OR3 (95%CI)
OR4 (95%CI)
Age (n = 384), yr
< 35 (n = 66)63 (95.5)3 (4.5)----
35-44 (n = 50)48 (96)2 (4)0.87 (0.14-5.44)0.65 (0.10-4.19)0.71 (0.094-5.50)0.27 (0.39-1.90)
45-54 (n = 45)41 (91.1)4 (8.9)2.04 (0.43-9.63)1.64 (0.33-7.96)1.85 (0.31-11.07)0.69 (0.13-3.64)
55-64 (n = 95)85 (89.5)10 (10.5)2.47 (0.65-9.34)1.63 (0.39-6.66)1.54 (0.30-7.93)0.70 (0.15-3.20)
65-74 (n = 63)37 (58.7)26 (41.3)14.7 (4.17-52.13)9.88 (2.62-37.17)9.91 (2.09-46.81)3.08 (0.73-13.01)
≥ 75 (n = 65)47 (72.3)18 (27.7)8.04 (2.23-28.90)5.80 (1.52-22.1)5.95 (1.23-28.80)2.10 (0.49-8.98)
Sex (n = 385)
Female (n = 191)165 (86.4)26 (13.6)----
Male (n = 194)157 (80.9)37 (19.1)1.49 (0.86-2.58)1.44 (0.78-2.65)1.43 (0.75-2.70)1.17 (0.58-2.36)
Ethnicity (n = 385)
African American (n = 257)204 (79.4)53 (20.6)----
European American (n = 26)23 (88.5)3 (11.5)0.50 (0.14-1.73)0.54 (0.14-1.96)0.38 (0.08-1.83)1.00 (0.22-4.50)
LatinX (n = 102)95 (93.1)7 (6.9))0.28 (0.12-0.64)0.52 (0.21-1.30)0.55 (0.21-1.47)0.64 (0.23-1.76)
BMI (n = 332)
Normal (n = 127)108 (85)19 (15)---
Overweight (n = 94)76 (80.9)18 (19.1)1.34 (0.66-2.73)1.02 (0.47-2.23)1.00 (0.46-2.19)
Obese (n = 111)89 (80.2)22 (19.8)1.40 (0.71-2.75)1.22 (0.58-2.56)1.18 (0.56-2.49)
Baseline comorbidities (no, always as reference)
Cardiac disease (n = 375)
No (n = 302)257 (85.1)45 (14.9)--
Yes (n = 73)55 (75.3)18 (24.7)1.86 (1.00-3.47)0.96 (0.47-1.95)
Diabetes mellitus (n = 377)
No (n = 236)202 (85.6)34 (14.4)--
Yes (n = 141)112 (79.4)29 (20.6)1.53 (0.89-2.65)1.15 (0.63-2.11)
Hypertension (n = 373)
No (n = 183)156 (85.2)27 (14.8)--
Yes (n = 190)155 (81.6)35 (18.4)1.30 (0.75-2.25)0.79 (0.42-1.51)
Immune suppression (n =369)
No (n = 355)282 (84.2)53 (15.8)--
Yes (n = 34)25 (73.5)9 (26.5)1.91 (0.84-4.33)2.19 (0.87-5.53)
Presenting symptoms
Fever (n = 383)
No (n = 174)149 (85.6)25 (14.4)--
Yes (n = 209)171 (81.8)38 (18.2)1.32 (0.76-2.29)1.07 (0.58-1.96)
Cough (n = 380)
No (n = 151)125 (82.8)26 (17.2)--
Yes (n = 229)193 (84.3)36 (15.7)0.89 (0.51-1.55)0.87 (0.46-1.63)
Shortness of breath (n = 381)
No (n = 144)133 (92.4)11 (7.6)----
Yes (n = 237)185 (78.1)52 (21.9)3.39 (1.70-6.75)3.64 (1.73-7.65)3.60 (1.71-7.56)2.38 (1.07-4.09)
Fatigue (n = 236)
No (n = 143)125 (87.4)18 (12.6)--
Yes (n = 93)80 (86)13 (14)1.12 (0.52-2.42)0.71 (0.30-1.67)
Nausea (n = 362)
No (n = 315)264 (83.8)51 (16.2)--
Yes (n = 47)42 (89.4)5 (10.6)0.61 (0.23-1.63)0.86 (0.30-2.50)
Vomiting (n = 375)
No (n = 332)277 (83.4)55 (16.6)--
Yes (n = 43)39 (90.7)4 (9.3)0.51 (0.17-1.50)0.631 (0.20-1.99)
Abdominal pain (n = 343)
No (n = 296)248 (83.8)48 (16.2)--
Yes (n = 47)44 (93.6)3 (6.4)0.35 (0.10-1.18) 0.50 (0.14-1.82)
Diarrhea (n =377)
No (n = 317)264 (83.3)53 (16.7)--
Yes (n = 60)52 (86.7)8 (13.3)0.76 (0.34-1.70)0.74 (0.31-1.78)
Anorexia (n = 325)
No (n = 238)208 (87.4)30 (12.6)--
Yes (n = 87)69 (79.3)18 (20.7)1.80 (0.94-3.44)1.30 (0.63-2.68)
Laboratory results (quartiles determined based on the entire study population; q1 always as reference)
Lymphocyte count (n = 380)
Normal (n = 193)177 (91.7)16 (8.3)--
Low (n = 163)121 (74.2)42 (25.8)3.84 (2.06-7.14)2.77 (1.41-5.45)
Elevated (n = 24)19 (79.2)5 (20.8)2.91 (0.95-8.83)3.27 (0.97-11.04)
CRP (n = 293)
Normal (n = 99)91 (919)8 (8.1)----
Elevated (n = 194)149 (76.8)45 (23.3)3.43 (1.55-7.61)3.19 (1.39-7.29)3.11 (1.38-7.04)2.77 (1.21-6.34)
D-Dimer (n = 309)
Normal (n = 39)39 (100)0 (0)L. Reg. N/A: No death for normal D-dimer; Chi-square P = 0.001 highly significant
Elevated (n = 270)212 (78.5)58 (21.5)
Procalcitonin (n = 276)
Normal (n = 163)151 (92.6)12 (7.4)--
Elevated (n = 113)67 (59.3)46 (40.7)8.63 (4.30-17.3)8.27 (3.95-17.3)
Ferritin (n = 273)
Normal (n = 98)88 (89.8)10 (10.2)--
Elevated (n = 175)131 (74.9)44 (25.1)2.95 (1.41-6.18)2.69 (1.24-5.82)
Hydroxychloroquine (n = 371)
No (n = 291)249 (80.8)42 (66.7)--
Yes (n = 80)59 (19.2)21 (33.3)2.11 (1.16, 3.83)1.93 (0.98 - 3.79)
ALP (n = 317)
Normal (n = 260)221 (85)39 (68.4)--
Elevated (n = 57)39 (15)18 (31.6) 2.61 (1.36 – 5.03)3.52 (1.65-7.51)
AST (n = 332)
Normal (n = 185)174 (94.1)11 (5.9)--
Elevated (n = 147)98 (66.7)49 (33.3)7.90 (3.93-15.9)8.01 (3.79-16.9)
ALT (n = 329)
Normal (n = 231)197 (85.3)34 (14.7)--
Elevated (n = 98)72 (73.5)26 (26.5)2.09 (1.17-3.73)2.64 (1.36-5.01)
Interventions (no as reference)
Glucocorticoids (n = 371)
No (n = 303)267 (88.1)36 (11.9)--
Yes (n = 68)41 (60.3)27 (39.7)4.88 (2.68-8.87)5.40 (2.72-10.7)
Mechanical ventilation (n = 376)
No (n = 320)303 (94.7)17 (5.3)--
Yes (n = 56)17 (30.4)39 (69.6)40.8 (19.3-86.5)35.2 (15.3-81.1)
OR1 = Crude, without any adjustment; OR2 = Adjusted for age, sex, ethnicity; OR3 = Multivariable, adjusted for age, sex, ethnicity, and other potential confounding variables (to be decided later). The final model suggest that Age, shortness of breath (SOB) and C-reactive protein (CRP) is significantly increase the risk of mortality. Baseline comorbidity, ethnicity and gender are not significant after controlling for SOB and CRP. BMI: Body mass index; CRP: C-reactive protein; ALP: Alkaline phosphatase; AST: Aspartate transaminase; ALT: Alanine transaminase.
  • Citation: Ashktorab H, Folake A, Pizuorno A, Oskrochi G, Oppong-Twene P, Tamanna N, Mehdipour Dalivand M, Umeh LN, Moon ES, Kone AM, Banson A, Federman C, Ramos E, Awoyemi EO, Wonni BJ, Otto E, Maskalo G, Velez AO, Rankine S, Thrift C, Ekwunazu C, Scholes D, Chirumamilla LG, Ibrahim ME, Mitchell B, Ross J, Curtis J, Kim R, Gilliard C, Mathew J, Laiyemo A, Kibreab A, Lee E, Sherif Z, Shokrani B, Aduli F, Brim H. COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome? World J Clin Cases 2021; 9(28): 8374-8387
  • URL: https://www.wjgnet.com/2307-8960/full/v9/i28/8374.htm
  • DOI: https://dx.doi.org/10.12998/wjcc.v9.i28.8374