Clinical features and risk factors associated with severe COVID-19 patients in China.
10.1097/CM9.0000000000001466
- Author:
Ning JIANG
1
;
Yan-Nan LIU
1
;
Jing BAO
1
;
Ran LI
1
;
Wen-Tao NI
1
;
Xing-Yu TAN
1
;
Yu XU
1
;
Li-Ping PENG
2
;
Xiao-Rong WANG
3
;
Yi-Ming ZENG
4
;
Dai-Shun LIU
5
;
Qing XUE
6
;
Jia-Shu LI
7
;
Ke HU
8
;
Ya-Li ZHENG
9
;
Zhan-Cheng GAO
1
Author Information
1. Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.
2. Department of Respiratory and Critical Care Medicine, The First Hospital of Jilin University, Changchun, Jilin 130021, China.
3. Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China.
4. Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China.
5. Department of Respiratory and Critical Care Medicine, The First People's Hospital of Zunyi, Zunyi, Guizhou 563000, China.
6. Department of Respiratory and Critical Care Medicine, Ningde People's Hospital, Ningde, Fujian 352000, China.
7. Department of Respiratory and Critical Care Medicine, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu 222061, China.
8. Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
9. Department of Respiratory, Critical Care, and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian 361111, China.
- Publication Type:Multicenter Study
- MeSH:
Adult;
COVID-19/pathology*;
China/epidemiology*;
Comorbidity;
Cough;
Cross-Sectional Studies;
Diarrhea;
Female;
Humans;
Male;
Middle Aged;
Retrospective Studies;
Risk Factors
- From:
Chinese Medical Journal
2021;134(8):944-953
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. In this study, we aimed to identify the risk factors for severe COVID-19 to improve treatment guidelines.
METHODS:A multicenter, cross-sectional study was conducted on 313 patients hospitalized with COVID-19. Patients were classified into two groups based on disease severity (nonsevere and severe) according to initial clinical presentation. Laboratory test results and epidemiological and clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression models were used to detect potential risk factors associated with severe COVID-19.
RESULTS:A total of 289 patients (197 nonsevere and 92 severe cases) with a median age of 45.0 (33.0, 61.0) years were included in this study, and 53.3% (154/289) were male. Fever (192/286, 67.1%) and cough (170/289, 58.8%) were commonly observed, followed by sore throat (49/289, 17.0%). Multivariate logistic regression analysis suggested that patients who were aged ≥ 65 years (OR: 2.725, 95% confidence interval [CI]: 1.317-5.636; P = 0.007), were male (OR: 1.878, 95% CI: 1.002-3.520, P = 0.049), had comorbid diabetes (OR: 3.314, 95% CI: 1.126-9.758, P = 0.030), cough (OR: 3.427, 95% CI: 1.752-6.706, P < 0.001), and/or diarrhea (OR: 2.629, 95% CI: 1.109-6.231, P = 0.028) on admission had a higher risk of severe disease. Moreover, stratification analysis indicated that male patients with diabetes were more likely to have severe COVID-19 (71.4% vs. 28.6%, χ2 = 8.183, P = 0.004).
CONCLUSIONS:The clinical characteristics of those with severe and nonsevere COVID-19 were significantly different. The elderly, male patients with COVID-19, diabetes, and presenting with cough and/or diarrhea on admission may require close monitoring to prevent deterioration.
