Clinical features and risk factors for severe inpatients with COVID-19: A retrospective study in China

Abstract

Background A worldwide outbreak of coronavirus disease (COVID-19), since 2019, has brought a disaster to people all over the world. Many researchers carried out clinical epidemiological studies on patients with COVID-19 previously, but risk factors for patients with different levels of severity are still unclear. Methods 562 patients with laboratory-confirmed COVID-19 from 12 hospitals in China were included in this retrospective study. Related clinical information, therapies, and imaging data were extracted from electronic medical records and compared between patients with severe and non-severe status. We explored the risk factors associated with different severity of COVID-19 patients by logistic regression methods. Results Based on the guideline we cited, 509 patients were classified as non-severe and 53 were severe. The age range of whom was 5–87 years, with a median age of 47 (IQR 35.0–57.0). And the elderly patients (older than 60 years old) in non-severe group were more likely to suffer from fever and asthma, accompanied by higher level of D-dimer, red blood cell distribution width and low-density lipoprotein. Furthermore, we found that the liver and kidney function of male patients was worse than that of female patients in both severe and non-severe groups with different age levels, while the severe females had faster ESR and lower inflammatory markers. Of major laboratory markers in non-severe cases, baseline albumin and the lymphocyte percentage were higher, while the white blood cell and the neutrophil count were lower. In addition, severe patients were more likely to be accompanied by an increase in cystatin C, mean hemoglobin level and a decrease in oxygen saturation. Besides that, advanced age and indicators such as count of white blood cell, glucose were proved to be the most common risk factors preventing COVID-19 patients from aggravating. Conclusion The potential risk factors found in our study have shown great significance to prevent COVID-19 patients from aggravating and turning to critical cases during treatment. Meanwhile, focusing on gender and age factors in groups with different severity of COVID-19, and paying more attention to specific clinical symptoms and characteristics, could improve efficacy of personalized intervention to treat COVID-19 effectively.

Asthma and COVID-19 risk: a systematic review and meta-analysis

“…Similarly, for ICU admission, while not statistically significant the pooled point estimate suggests a possible 21% increased risk of ICU admission from COVID-19 for people with asthma (95% CI −3% to 51%). One study from China (Wang [ 40 ]) and another from Kuwait (Almazeedi [ 41 ]) reported a risk ratio of 5.16 and 4.08 respectively, far greater than in other studies. These differences in risk may be linked to resource allocation and availability or difference in vulnerability due to ethnicity or other environmental factors.…”

Cystatin C, COVID-19 severity and mortality: a systematic review and meta-analysis

“…Eleven studies were retrospective [ 30 – 32 , 34 – 37 , 39 – 42 ], whilst the remaining two were prospective [ 33 , 38 ]. Endpoints included disease severity based on current clinical guidelines (8 studies) [ 31 , 33 – 35 , 37 , 39 , 40 , 42 ], disease progression (one study) [ 38 ] and occurrence of acute respiratory distress syndrome (ARDS) (one study) [ 36 ], and survival status (4 studies) [ 30 , 32 , 36 , 41 ]. Only two studies reported the presence of AKI [ 32 , 39 ].…”

Serum hydroxybutyrate dehydrogenase and COVID-19 severity and mortality: a systematic review and meta-analysis with meta-regression

“…2 . In all studies, patients with high severity or non-survivor status had higher HBDH concentrations when compared to those with low severity or survivor status (mean difference range, 0.04 to 2.45), although the difference was not statistically significant in two studies [ 40 , 53 ]. The pooled results confirmed that HBDH concentrations on admission were significantly higher in patients with high severity or non-survivor status (SMD = 0.90, 95% CI 0.74 to 1.07, p < 0.001) (Fig.…”