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

Authors
  • Li, Xiaochen1
  • Xu, Shuyun1
  • Yu, Muqing1
  • Wang, Ke1
  • Tao, Yu1
  • Zhou, Ying1
  • Shi, Jing1
  • Zhou, Min1
  • Wu, Bo2
  • Yang, Zhenyu1
  • Zhang, Cong1
  • Yue, Junqing1
  • Zhang, Zhiguo3
  • Renz, Harald4
  • Liu, Xiansheng1
  • Xie, Jungang1
  • Xie, Min5
  • Zhao, Jianping6
  • 1 Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China. , (China)
  • 2 United Imaging Healthcare Co Ltd, Wuhan, China. , (China)
  • 3 School of Medicine and Health Management, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. , (China)
  • 4 Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg University Hospital Giessen and Marburg GmbH, Marburg, Germany. , (Germany)
  • 5 Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China. Electronic address: [email protected] , (China)
  • 6 Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China. Electronic address: [email protected] , (China)
Type
Published Article
Journal
The Journal of allergy and clinical immunology
Publication Date
Jul 01, 2020
Volume
146
Issue
1
Pages
110–118
Identifiers
DOI: 10.1016/j.jaci.2020.04.006
PMID: 32294485
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. We sought to evaluate the severity on admission, complications, treatment, and outcomes of patients with COVID-19. 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. 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-α), 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. 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. Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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