Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:146

Article

Li, Xiaochen^1,2,3  Xu, Shuyun^1,2,3  Yu, Muqing^1,2,3  Wang, Ke^1,2,3  Tao, Yu^1,2,3  Zhou, Ying^1,2,3  Shi, Jing^1,2,3  Zhou, Min^1,2,3  Wu, Bo⁴  Yang, Zhenyu^1,2,3  Zhang, Cong^1,2,3  Yue, Junqing^1,2,3  Zhang, Zhiguo⁵  Renz, Harald⁶  Liu, Xiansheng^1,2,3  Xie, Jungang^1,2,3  Xie, Min^1,2,3  Zhao, Jianping^1,2,3 

[1] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Pulm & Crit Care Med, Wuhan, Peoples R China

[2] Natl Minist Hlth Peoples Republ China, Key Lab Resp Dis, Wuhan, Peoples R China

[3] Natl Clin Res Ctr Resp Dis, Wuhan, Peoples R China

[4] United Imaging Healthcare Co Ltd, Wuhan, Peoples R China

[5] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Sch Med & Hlth Management, Wuhan, Peoples R China

[6] Philipps Univ Marburg, Univ Hosp Giessen & Marburg GmbH, Inst Lab Med & Pathobiochem, Mol Diagnost, Marburg, Germany

关键词: COVID-19;    SARS-CoV-2;    risk factors;    severity;    mortality;   

DOI  :  10.1016/j.jaci.2020.04.006

来源: Elsevier

【 摘 要 】

Background: In December 2019, the coronavirus disease 2019 (COVID-19) outbreak occurred in Wuhan. Data on the clinical characteristics and outcomes of patients with severe COVID-19 are limited. Objective: We sought to evaluate the severity on admission, complications, treatment, and outcomes of patients with COVID-19. Methods: Patients with COVID-19 admitted to Tongji Hospital from January 26, 2020, to February 5, 2020, were retrospectively enrolled and followed-up until March 3, 2020. Potential risk factors for severe COVID-19 were analyzed by a multivariable binary logistic model. Cox proportional hazard regression model was used for survival analysis in severe patients. Results: We identified 269 (49.1%) of 548 patients as severe cases on admission. Older age, underlying hypertension, high cytokine levels (IL-2R, IL-6, IL-10, and TNF-alpha), and high lactate dehydrogenase level were significantly associated with severe COVID-19 on admission. The prevalence of asthma in patients with COVID-19 was 0.9%, markedly lower than that in the adult population of Wuhan. The estimated mortality was 1.1% in nonsevere patients and 32.5% in severe cases during the average 32 days of follow-up period. Survival analysis revealed that male sex, older age, leukocytosis, high lactate dehydrogenase level, cardiac injury, hyperglycemia, and high-dose corticosteroid use were associated with death in patients with severe COVID-19. Conclusions: Patients with older age, hypertension, and high lactate dehydrogenase level need careful observation and early intervention to prevent the potential development of severe COVID-19. Severe male patients with heart injury, hyperglycemia, and high-dose corticosteroid use may have a high risk of death.

【 授权许可】

Free