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2020 ; 146
(1
): 110-118
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Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan
#MMPMID32294485
Li X
; Xu S
; Yu M
; Wang K
; Tao Y
; Zhou Y
; Shi J
; Zhou M
; Wu B
; Yang Z
; Zhang C
; Yue J
; Zhang Z
; Renz H
; Liu X
; Xie J
; Xie M
; Zhao J
J Allergy Clin Immunol
2020[Jul]; 146
(1
): 110-118
PMID32294485
show ga
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-?), 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.
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