Clinical Features of COVID-19 Patients with Different Outcomes in Wuhan: A Retrospective Observational Study

Wang, Zhen; Ye, Di; Wang, Menglong; Zhao, Mengmeng; Li, Dan; Ye, Jing; Liu, Jianfang; Xu, Yao; Zhang, Jishou; Pan, Wei; Liu, Meilin; Luo, Zhen; Wan, Jun

doi:10.1155/2020/2138387

Cited by 33 publications

(41 citation statements)

References 28 publications

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“…Comorbidities including hypertension and diabetes mellitus are associated with mortality in patients with COVID-19 10 , 28 , 29 . In addition, complications including shock, acute heart injury, kidney injury and liver injury are commonly observed in severe or critical patients with COVID-19 and can also increase the risk of developing severe illness and poor outcomes 30 , 31 . In our study, the obesity group had a higher proportion of patients with preexisting diseases; in particular, patients with hypertension.…”

Section: Discussionmentioning

confidence: 99%

The Association between Obesity and Severity in Patients with Coronavirus Disease 2019: a Retrospective, Single-center Study, Wuhan

Zhang¹,

Xu²,

Shen³

et al. 2021

Int. J. Med. Sci.

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Aim: In other respiratory infectious diseases, obesity may be associated with a poor outcome. For coronavirus disease 2019 (COVID-19), the association between obesity and severity or prognosis requires further analysis. Methods: This was a retrospective, single-center study. Hospitalized patients were recruited in Renmin Hospital of Wuhan University from January 2, 2020 to February 20, 2020. The data of body mass index (BMI) was obtained from follow-up of surviving patients. According to BMI, normal weight was defined as 18.5-23.9 kg/m 2 , overweight as 24.0-27.9 kg/m 2 and obesity as > 28.0 kg/m 2 . Results: A total of 463 patients were enrolled, of which 242 (52.3%) patients were in the normal weight group; 179 (38.7%) were in the overweight group; and 42 (9.1%) were in the obesity group. Compared to the normal group, obese patients were more likely to have a higher heart rate; lower finger oxygen saturation; higher levels of white blood cells, neutrophil counts, basophil counts, intravenous glucose, triacylglycerol, uric acid, alanine aminotransferase, creatine kinase-MB, CD19+ cell counts and percentage; and lower levels of monocyte percentage, high density lipoprotein and CD3+ cell percentage. In addition, the proportions of hypertension (21.5% vs. 42.6%) and severe+critical illness (47.8 vs. 81.0 %) were significantly higher in the obesity group than those in normal group. However, no significant differences were observed between the normal and obesity groups in critical illness, organ damage and defined endpoint (mechanical ventilation or intensive care unit). Multiple logistic regression showed that obesity increased the risk of developing severe+critical illness (Odd ratio 3.586, 95% CI 1.550-8.298, P=0.003) in patients with COVID-19, and did not affect the risk of critical illness, organ damage and endpoints. Overweight did not affect the risk of severity, organ damage or endpoint in patients with COVID-19. Conclusion: Obesity may be a risk factor for developing severity in patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

The Association between Obesity and Severity in Patients with Coronavirus Disease 2019: a Retrospective, Single-center Study, Wuhan

Zhang¹,

Xu²,

Shen³

et al. 2021

Int. J. Med. Sci.

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“…Like diabetes, hypertension was also identified as a determinant of COVID-19 mortality in 4 out of the 16 studies (11, 16, 24, 30). Furthermore, 4 of 11 studies on BMI and COVID-19 mortality showed that obesity significantly determines COVID-19 mortality (11, 18, 19, 32).…”

Section: Resultsmentioning

confidence: 98%

“…Age and sex were the common demographic risk factors. Of the 20 studies on age and COVID-19 mortality, 16 identified increasing age as a significant determinant of COVID-19 mortality, with effect sizes ranging from 1.04 to 20.6 and 95% CI from 1.01 to 22.68 (9, 10, 11, 16, 17, 18, 24, 25, 26, 27, 28, 29, 30, 32, 33, 35). Also, 8 of the 20 studies on gender/sex and COVID-19 found men to have a higher risk of COVID-19 mortality than women (10, 11, 16, 17, 24, 26, 28, 32).…”

Section: Resultsmentioning

confidence: 99%

“…Of biological/medical risk factors, the review identified diabetes (n=6), Chronic kidney/renal disease (CKD) (n=5), hypertension (n=4), C-reactive protein (CRP) (n=4), BMI (n=4), dyspnoea (n=3), COPD (n=3), cancer (n=3), coronary heart disease (n=2), asthma (n=2) and D-dimer (n=2) as determinants of COVID-19 mortality. Of the 10 studies that included CKD in their analysis, 5 found it a significant determinant of COVID-19 mortality (18, 25, 26, 30, 35). Additionally, out of the 5 studies that investigated the influence of CRP on COVID-19 mortality, 4 showed that elevated CRP in the blood (at least >5mg/L) increases the risk of COVID-19 death (11, 24, 26, 29).…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, out of the 5 studies that investigated the influence of CRP on COVID-19 mortality, 4 showed that elevated CRP in the blood (at least >5mg/L) increases the risk of COVID-19 death (11, 24, 26, 29). Also, people with diabetes were found to have a higher risk of COVID-19 mortality in 6 of the 18 studies on diabetes and COVID-19 mortality (16, 17, 18, 26, 30, 32)…”

Section: Resultsmentioning

confidence: 99%

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Determinants of COVID-19 outcomes: A systematic review

Crankson

Pokhrel

Anokye

2021

Preprint

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Background: The current pandemic, COVID-19, caused by a novel coronavirus SARS-CoV-2 has claimed over a million lives worldwide in a year, warranting the need for more research into the wider determinants of COVID-19 outcomes to support evidence-based policies. Objective: This study aimed to investigate what factors determined the mortality and length of hospitalisation in individuals with COVID-19. Data Source: This is a systematic review with data from four electronic databases: Scopus, Google Scholar, CINAHL and Web of Science. Eligibility Criteria: Studies were included in this review if they explored determinants of COVID-19 mortality or length of hospitalisation, were written in the English Language, and had available full-text. Study appraisal and data synthesis: The authors assessed the quality of the included studies with the Newcastle Ottawa Scale and the Agency for Healthcare Research and Quality checklist, depending on their study design. Risk of bias in the included studies was assessed with risk of bias assessment tool for non-randomised studies. A narrative synthesis of the evidence was carried out. Results: The review included 22 studies from nine countries, with participants totalling 239,830. The included studies quality was moderate to high. The identified determinants were categorised into demographic, biological, socioeconomic and lifestyle risk factors, based on the Dahlgren and Whitehead determinant of health model. Increasing age (ORs 1.04-20.6, 95%CIs 1.01-22.68) was the common demographic determinant of COVID-19 mortality while living with diabetes (ORs 0.50-3.2, 95%CIs -0.2-0.74) was one of the most common biological determinants of COVID-19 length of hospitalisation. Review limitation: Meta-analysis was not conducted because of included studies heterogeneity. Conclusion: COVID-19 outcomes are predicted by multiple determinants, with increasing age and living with diabetes being the most common risk factors. Population-level policies that prioritise interventions for the elderly population and the people living with diabetes may help mitigate the outbreak's impact.

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