A brief-review of the risk factors for covid-19 severity

Rod, J.E.; Oviedo-Trespalacios, Óscar; Cortes-Ramirez, Javier

doi:10.11606/s1518-8787.2020054002481

Cited by 202 publications

(222 citation statements)

References 20 publications

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“…Some situations involved in the pathogenesis of late-onset preeclampsia, as predisposing cardiovascular or metabolic factors for endothelial dysfunction, or a systemic hyperinflammatory status have also been described as triggers of COVID-19 severity [15]. Among the presenting symptoms and complementary tests related to a higher risk of hospitalization in our study, fever and CRP have been previously described to have a high consistency of association with COVID-19 severe forms [16]. Regarding dyspnea, previous publications have suggested its presence in 60-70% of healthy pregnant women, therefore distinguish whether it is a physiological event or a pathological finding in these patients may be essential in the severity assessment [17].…”

Section: Discussionsupporting

confidence: 59%

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

Barbero

Mugüerza

Herraı̀z

et al. 2020

The Journal of Maternal-Fetal & Neonatal Medicine

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Background: There is little evidence about how novel coronavirus (SARS-CoV-2) affects pregnant women and their newborns. Comparisons with other members of the coronavirus family responsible for severe acute respiratory syndrome (SARS) have been done to predict maternal and neonatal outcomes; however, more information is required to establish clinical patterns, disease evolution and pregnancy prognosis in this group of patients. Methods: This paper is reporting a series of 91 women diagnosed with SARS-CoV-2 infection during pregnancy and puerperium. The analysis showed that 40 patients developed pneumonia, bilateral in most cases, with a 46.2% rate of hospitalization and 4 patients requiring intensive care unit (ICU) admission. In confront with previous publications, we have found a higher rate of coronavirus disease (COVID-19) severe forms, even when compared to non-pregnant women with the same baseline characteristics. We have analyzed the demographic characteristics, pregnancy-related conditions and presenting symptoms to identify features that could determine which patients will need hospitalization because of COVID-19 (Group 1-G1) and those who not (Group 2-G2). We have found that obesity and Latin-American origin behave as risk factors: OR: 4.3; 95% CI: 1.4-13.2, and OR: 2.6; 95% CI: 1.1 À 6.2, respectively. Among the 23 patients that delivered with active SARS-CoV-2, the overall rate of cesarean section (CS) and preterm birth were 52.2% and 34.8%, respectively, but we observed that the rate of CS was even higher in G1 compared to G2: 81.8% versus 25%, p ¼ .012. However, prematurity was equally distributed in both groups and only one preterm delivery was determined by poor maternal condition. There were no deaths among the patients neither their newborns. Conclusion: In conclusion, the results of our cohort reveal that SARSC-CoV-2 infection may not behave as mild as suggested during pregnancy, especially when factors as obesity or Latin-American origin are present. No evidence of late vertical transmission was noticed but prematurity and high CS rate were common findings, although it is difficult to establish any causality between these conditions and COVID-19. Further evidence is required to establish if pregnancy itself can lead to severe forms of COVID-19 disease and whether risk factors for the general population are applicable to obstetric patients. Until larger studies are available, pregnant women should be monitored carefully to anticipate severe complications.

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Section: Discussionsupporting

confidence: 59%

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

Barbero

Mugüerza

Herraı̀z

et al. 2020

The Journal of Maternal-Fetal & Neonatal Medicine

View full text Add to dashboard Cite

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“…Identifying the death risk associated with critically ill patients early and giving these patients priority treatment in a timely manner are particularly important in global health emergencies. Studies have shown that a total of 60 predictors can assess the severity of COVID-19, of which 7 factors are considered to be highly correlated and consistent, including SOFA score, age, D-dimer, hs-CRP, body temperature, albumin and diabetes [13] . The results of this study revealed that SOFA score, age, CKD, CLD1, CLD2, cystatin C, hs-CRP, CK, CK-MB and other factors were independent risk factors for in-hospital death, which was similar to the results of the above study.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of the SOFA score in patients with COVID-19: a retrospective, observational study

Yang

Huang

et al. 2020

Preprint

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Background Patients with Coronavirus disease 2019 (COVID-19) have a high mortality rate, and thus, it is particularly important to predict the severity and prognosis of COVID-19. The Sequential Organ Failure Assessment (SOFA) score has been used to predict the clinical outcomes of patients with multiple organ failure requiring intensive care. Therefore, we retrospectively analyzed the clinical characteristics, risk factors, and relationship between the SOFA score and the prognosis of COVID-19 patients. Methods Clinical variables were compared between patients with mild and severe COVID-19. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for severe COVID-19. The Cox proportional hazards model was used to analyze risk factors for hospital-related death. Survival analysis was performed by the Kaplan-Meier method, and survival differences were assessed by the log-rank test. Receiver operating characteristic (ROC) curves of the SOFA score in different situations were drawn, and the area under the ROC curve was calculated. Results The median SOFA score of all patients was 2 (IQR, 1–3). Patients with severe COVID-19 exhibited a significantly higher SOFA score than patients with mild COVID-19 [3 (IQR, 2–4) vs 1 (IQR, 0–1); P < 0.001]. The SOFA score increased the risk of severe COVID-19, with an odds ratio of 5.851 (95% CI: 3.044–11.245; P < 0.001). The area under the ROC curve (AUC) was used to evaluate the diagnostic accuracy of the SOFA score in predicting severe COVID-19 [cutoff value = 2; AUC = 0.908 (95% CI: 0.857–0.960); sensitivity: 85.20%; specificity: 80.40%] and the risk of death in COVID-19 patients [cutoff value = 5; AUC = 0.995 (95% CI: 0.985-1.000); sensitivity: 100.00%; specificity: 95.40%]. Regarding the 60-day mortality rates of patients in the two groups classified by the optimal cutoff value of the SOFA score (5), patients in the high SOFA score group (SOFA score ≥ 5) had a significantly greater risk of death than those in the low SOFA score group (SOFA score < 5). Conclusion The SOFA score could be used to evaluate the severity and 60-day mortality of COVID-19. The SOFA score may be an independent risk factor for in-hospital death.

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“…Estrogen modulates the immune response and contributes to the production of more antibodies. 7 On the other hand, men have less antibodies that decrease the expression of IL-6, which is linked to deregulation of the immune system and lung damage. Likewise, men have higher concentrations of angiotensin-converting enzyme 2 (ACE2) in the alveolar membrane of the lungs through which SARS-CoV-2 enters and infects its host.…”

Section: Discussionmentioning

confidence: 99%

“…4 People with a previous diagnosis of non-communicable diseases (NCDs) such as high blood pressure (HBP), type 2 diabetes (T2D), cardiovascular disease (CVD), and chronic obstructive pulmonary disease (COPD), [5][6] as well as those who are older or men, are more likely to develop serious conditions of COVID- 19 or die from this cause. 7 In China, the fatality rate (number of deaths per 100 infected) for COVID-19 was 2.3%. However, it was 6.0% for people with hypertension, 7.3% for adults with diabetes and 10.5% for people with cardiovascular disease 10.5%.…”

Section: Introductionmentioning

confidence: 99%

Impact of a Double Epidemic in Mexico: Non-Communicable Diseases Increase the Case Fatality Rate with Covid-19

Monterrubio‐Flores

Ramírez-Villalobos

Espinoza-Montero

et al. 2020

Preprint

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Background: People with a previous diagnosis of non-communicable diseases (NCDs) develop serious forms of COVID-19 or die. Mexico is the sixth country with the highest mortality rate by COVID-19 with high mortality in younger adults.Objectives: To describe the association between NCDs and Case Fatality Rate (CFR) due to COVID-19 and identify related factors. Methods: We studied all Mexican adults infected with COVID-19 from February 1st to July 31st, 2020. The data set is available for free on the Ministry of Health’s webpage. We analyzed previous diagnosis of NCDs, other preexisting diseases, indicators of severity, and the institution treating the patient. We estimated CFR and analyzed it by the number of NCDs, specific diseases, and combinations of NCDs. Relative risk was estimated using Poisson models and probability of death estimates with Logistic models.Results: We analyzed 406,966 COVID-19 positive adults. The general CFR was 11.2%, while for men it was 13.7% and for women 8.4%. CFR is positively associated with age and number of NCDs (trend test p<0.001). The combination of type 2 diabetes+chronic kidney failure has the highest CFR (44.0%). The number of comorbidities increase the CFR in younger adults, in which the relative risk from 0 to 3 or more NCDs was 30.2 in women and 11.8 in men. We observed great heterogeneity in the CFR by institution, from 4.6% in private institutions to 18.9% in public institutions.Conclusion: The number of NCDs increases CFR and explains the mortality in younger adults. Our findings are consistent with the scientific literature and contribute to the understanding of these associations.

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A brief-review of the risk factors for covid-19 severity

Cited by 202 publications

References 20 publications

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

The prognostic value of the SOFA score in patients with COVID-19: a retrospective, observational study

Impact of a Double Epidemic in Mexico: Non-Communicable Diseases Increase the Case Fatality Rate with Covid-19

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