Clinical characteristics and risk factors for mortality among inpatients with COVID‐19 in Wuhan, China

Abstract

Coronavirus disease 2019 (COVID-19) has become the worldwide pandemic. Currently, COVID-19, caused by the novel coronavirus, has had outbreaks in more than 213 countries and regions around the world and has caused many deaths. As of 24 April 2020, more than 2.62 million people had been diagnosed worldwide, of whom more than 180 000 died from the virus. 1 This cohort included COVID-19 patients admitted to The Central Hospital of Wuhan on 1 January 2020 to 15 February 2020. Of the 660 participating inpatients with COVID-19, 82 died and 578 were discharged. We comprehensively identified the clinical characteristics at the time of admission in nonsurvivors and patients who recovered from it (Table 1), and we reported several novel risk factors of mortality in COVID-19 patients (Figure 1A). Furthermore, dynamic changes in these major markers during hospitalization and the survival outcomes under different conditions were tracked (Figure 1B-E).Consistent with the previous study, advanced age and high SOFA scores on admission were crucial risk factors for COVID-19 patient mortality. 2 Intriguingly, according to our multivariable logistic regression analysis, we discovered that a history of cerebral infarction, C-reactive protein (CRP) levels >0.6 mg/dL, and lactate dehydrogenase levels >245 U/L on admission significantly elevated the odds of in-hospital death (Figure 1A).Our findings show that the history of cerebral infarction, an independent risk factor for inpatient death, caused a significantly poorer outcome for COVID-19 patients. The possible reasons are as follows. First, cerebral infarction may occur mainly in elderly people, and older age was a crucial predictor for COVID-19 mortality. 2 Second, when cerebral infarction impacts respiratory muscles and respiratory centers or causes hemiplegia, it may cause pulmonary conditions to deteriorate. 3 Third, hypercoagulability is associated with cerebral infarction, and cerebral infarction patients may have preexisting hypercoagulability. 4 Additionally, we observed higher D-dimer in nonsurvivors, suggesting that COVID-19 patients with cerebral infarction may have an aggravatingThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Acute kidney injury is associated with severe infection and fatality in patients with COVID-19: A systematic review and meta-analysis of 40 studies and 24,527 patients

“…In this meta-analysis, there were 40 studies with 24,377 patients used to assess the incidence of AKI in COVID-19 patients [ 5 , 13 , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] ]. We found that the incidence of AKI was 10 % (95 % CI 8%–13 %) in COVID-19 patients, but there was evidence of statistical heterogeneity among the studies, with I 2 = 98 %.…”

Diabetes Mellitus is Associated with Severe Infection and Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis

“…The flow of studies through our meta-analysis is depicted in Figure 1 . A total of 76 studies with 31,067 patients were eventually included in our study ( 8 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , ...…”

The Effect of Anticoagulation Use on Mortality in COVID-19 Infection

“…Of those, 2,876 were taking anticoagulants. Heparin was used in 3 studies, 3 , 4 , 5 whereas the type of anticoagulant was not specified in the other 3 studies. 6 , 7 , 8 In one study, heparin was used in prophylactic doses, 4 whereas anticoagulation was used in therapeutic doses in 2 studies.…”