{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:11:22Z","timestamp":1789164682952,"version":"build-2803163510"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:00:00Z","timestamp":1616716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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 (HR\n                      <jats:sub>CS<\/jats:sub>\n                      ) for the effect of preselected factors on the absolute risk of death and recovery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      1,006 patients were included (63.9% male; median age 69 years, IQR: 58\u201377). Patients were hospitalized for a median duration of 6 days (IQR: 3\u201313); 243 (24.6%) of them died, 689 (69.9%) recovered, and 74 (7.4%) were censored. Patients with higher age (HR\n                      <jats:sub>CS<\/jats:sub>\n                      1.10, 95% CI 1.08\u20131.12), immunocompromised state (HR\n                      <jats:sub>CS<\/jats:sub>\n                      1.46, 95% CI 1.08\u20131.98), who used anticoagulants or antiplatelet medication (HR\n                      <jats:sub>CS<\/jats:sub>\n                      1.38, 95% CI 1.01\u20131.88), with higher modified early warning score (MEWS) (HR\n                      <jats:sub>CS<\/jats:sub>\n                      1.09, 95% CI 1.01\u20131.18), and higher blood LDH at time of admission (HR\n                      <jats:sub>CS<\/jats:sub>\n                      6.68, 95% CI 1.95\u201322.8) had increased risk of death, whereas fever (HR\n                      <jats:sub>CS<\/jats:sub>\n                      0.70, 95% CI 0.52\u20130.95) decreased risk of death. We found no increased mortality risk in male patients, high BMI or diabetes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0249231","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T13:36:18Z","timestamp":1616765778000},"page":"e0249231","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Risk factors for in-hospital mortality in laboratory-confirmed COVID-19 patients in the Netherlands: A competing risk survival analysis"],"prefix":"10.1371","volume":"16","author":[{"given":"Gerine","family":"Nijman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maike","family":"Wientjes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4431-7395","authenticated-orcid":true,"given":"Jordache","family":"Ramjith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9629-8627","authenticated-orcid":true,"given":"Nico","family":"Janssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobien","family":"Hoogerwerf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evertine","family":"Abbink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Blaauw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ton","family":"Dofferhoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"van Apeldoorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Veerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quirijn","family":"de Mast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap","family":"ten Oever","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"Hoefsloot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique H.","family":"Reijers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinout","family":"van Crevel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7351-4596","authenticated-orcid":true,"given":"Josephine S.","family":"van de Maat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,26]]},"reference":[{"key":"pone.0249231.ref001","unstructured":"Dutch National Institute for Public Health and the Environment (RIVM). 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