An evidence-based model for predicting adverse outcome in COVID-19 patients with comorbid pathology

Mayra Ashirova

2025

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DOI 10.54500/2790-1203-2025-3-125-amj007
Data confidence 70 medium
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Abstract

The COVID-19 pandemic has placed an unprecedented burden on health care systems, highlighting the critical need for intensive care and respiratory support. The severe course of COVID-19, complicated by multi-organ failure, often results in prolonged hospitalisation in intensive care units. A thorough understanding of risk and protective factors is necessary to optimise treatment strategies and protect the healthcare system from overload.Objective: To study risk factors associated with the prevalence and severity of COVID-19 in the adult population to improve patient stratification and optimize therapy.Methods: This study is a retrospective, cohort study. Weretrospectivelyanalysed 511 medical records from 3696 patients with confirmed SARS-CoV-2 infectionwho were observed in the City Infectious Diseases Hospital of Shymkent, Kazakhstan inthe period from January to October 2021. Patients were divided into 2 groups: maingroup (n=327) -with comorbidities, control group (n=184) -without comorbidities. Results.The analysis revealed a set of demographic, clinical (symptoms,complications), immunological (cytokine storm), haematological (leukocyteand plateletlevels), biochemical (factor VIII, protein C) and radiological (changes in lung tissue)factors that can be used to predict the course of COVID-19. The association ofcomorbidities (hypertension, diabetes) with increased risk of severecourse of the diseasewas confirmed. Hypoxia plays a key role in the development of multi-organ failure.Inflammatory markers (C-reactive protein, ferritin, D-dimer) and pro-inflammatorycytokines (IL-6, IL-1) are predictors of unfavourable outcomes.Identification and validation of risk factors and prognostic markers inCOVID-19 is crucial for patient stratification, timely identification of high-risk groupsand development of individualised treatment strategies.Conclusions.Age, gender, presence of comorbidities, immunological and laboratorymarkers play an important role in determining the severity of COVID-19. Further studiesare needed to validate these risk factors and develop clinical guidelines to improveoutcomes inpatients with COVID-19.Key words:COVID-19, predictors, SARS-CoV-2, severity, comorbidity.