Objective: Since December 2019, an outbreak of coronavirus disease 2019 (COVID 19) has been experienced from Wuhan, China to the world. A retrospective cohort study was conducted to summarize the clinical characteristics of patients with COVID-19 and to explore the risk factors affecting the disease duration in Jiangan Fangcang shelter hospital, Wuhan, China. Methods: Clinical characteristics of 409 patients with COVID-19 were retrospectively analyzed. We describe the clinical characteristics and distribution of discharge time or transfer time for each patient. Then we performed univariate and multivariate Cox regression analysis to identify potential risk factors for progression from non-severe to severe COVID-19 or death. Results: The median disease duration of all patients was 23 days (IQR 19-28). The main symptoms of the patient were fever (95.6%), cough (74.3%), tiredness (21.5%), and so on. Comorbidities mainly included hypertension (30.6%) diabetes (17.6%) and heart disease (12.5%). The univariate Cox regression analysis showed that old age, number of symptoms, the combination of hypertension, heart disease and pulmonary disease were associated with the progression of disease. The multivariate Cox regression analysis showed that old age (HR: 7.294; 95% CI: 1.442-36.888; P = 0.016), the combination of hypertension (HR: 2.230; 95% CI: 1.090-4.562; P = 0.028) and heart disease (HR: 2.650; 95% CI: 1.079-6.510; P = 0.034) were independent risk factors for progression of COVID-19. Conclusions: The age of the patient, the combination of hypertension and heart disease were independent risk factors for the progression of COVID-19. Cautions should be raised for patients with these risk factors.
Objective Malnutrition has a high occurrence in patients with chronic heart failure (CHF). The prevalence of malnutrition and its impact on all-cause mortality in patients with CHF were assessed using a meta-analysis. Methods PubMed, Embase, the Cochrane Library, Web of Science, Medline, CBM, CNKI, WANFANG DATA, and VIP databases were searched to collect cross-sectional and cohort studies on malnutrition, and the prevalence and all-cause mortality of patients with CHF were determined. The time of retrieval was from the database establishment to May 2021. Two researchers independently performed screening of the literature, data extraction and assessed the risk of bias in the included studies. Then Stata 16.0 software was used for meta-analysis. Results A total of 10 cross-sectional and 21 cohort studies were included, including 12537 patients with CHF. A meta-analysis demonstrated that the total prevalence of malnutrition in patients with heart failure was 46% (95% confidence interval [CI]: 0.43, 0.49). Compared to patients with non-malnutrition, malnutrition increased the risk of all-cause mortality in patients with CHF (hazard ratio = 2.15, 95% CI [1.89, 2.45], P < 0.05). Discussion Current evidence suggests that the prevalence of malnutrition is high among patients with CHF. The risk of all-cause mortality in such patients can be increased by malnutrition. Therefore, the risk of malnutrition in patients with CHF should be considered to reduce the occurrence of adverse clinical outcomes.
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