Background The mortality rate from acute respiratory distress syndrome (ARDS) is high among hospitalized patients with coronavirus disease 2019 (COVID-19). Hence, risk evaluation tools are required to immediately identify high-risk patients upon admission for early intervention. Methods A cohort of 220 consecutive patients with COVID-19 were included in this study. To analyze the risk factors of ARDS, data obtained from approximately 70% of the participants were randomly selected and used as training dataset to establish a logistic regression model. Meanwhile, data obtained from the remaining 30% of the participants were used as test dataset to validate the effect of the model. Results Lactate dehydrogenase, blood urea nitrogen, D-dimer, procalcitonin, and ferritin levels were included in the risk score system and were assigned a score of 25, 15, 34, 20, and 24, respectively. The cutoff value for the total score was > 35, with a sensitivity of 100.00% and specificity of 81.20%. The area under the receiver operating characteristic curve and the Hosmer–Lemeshow test were 0.967 (95% confidence interval [CI]: 0.925–0.989) and 0.437(P Value = 0.437). The model had excellent discrimination and calibration during internal validation. Conclusions The novel risk score may be a valuable risk evaluation tool for screening patients with COVID-19 who are at high risk of ARDS.

Objectives: The role of corticosteroids in the treatment of COVID-19 is controversial. In this paper, we intend to study the application value of corticosteroid in critically ill patients with COVID-19.Methods: We collected data from 120 patients who were diagnosed with COVID-19 in the Wuhan Union Hospital. In the first part of this study, the outcome of patients given corticosteroids was compared with that of patients not given corticosteroids. The second part of the study was a matched (1:1) case–control study. After matching the baseline characteristics between the two groups, the effect of corticosteroid use on the outcome was analyzed again.Results: Analysis of data without adjusting differences in baseline characteristics indicated that the proportion of mechanical ventilation and the mortality was higher in the corticosteroid treatment group in severely ill patients. The length of hospitalization and viral shedding have no significant difference between the two groups. After adjusting the difference between the corticosteroid and non-corticosteroid treatment group, analysis revealed that the use of corticosteroids had no effect on the outcome.Conclusions: Among the critically ill patients, the use of corticosteroids has no effect on length of hospitalization, viral shedding or mortality rates.

The role of corticosteroids in the treatment of coronavirus disease 2019 (COVID-19) is controversial. In the present study, we evaluated the effects of adjuvant corticosteroids treatment on the outcome of patients with COVID-19 (n=966), using Propensity Score Matching to adjust for potential differences between the corticosteroids group (n=289) and the non-corticosteroids group (n=677). Analysis of data without adjusting differences in baseline characteristics indicated that the proportion of mechanical ventilation and the mortality was higher in the corticosteroids treatment group in total or severe/critical patients. The duration of viral shedding was longer in the non-corticosteroids treatment group in total or general/mild patients. After adjusting the difference between the corticosteroids and non-corticosteroids treatment group, the analysis revealed that the use of corticosteroids had no effect on the duration of viral shedding, in-hospital mortality or 28day mortality.