Risk factors for disease progression in hospitalized patients with COVID-19: a retrospective cohort study

Abstract

Background: To investigate the risk factors related to aggravation and clinical outcomes in coronavirus disease 2019 (COVID-19) patients. Methods:We performed a retrospective study on the risk factors for disease progression of cases with COVID-19. Based on the clinical types, the patients were divided into a progression group and an improvement group. Multivariable logistic regression and ROC curve analysis were performed to explore the risk factors for disease progression.Results: A total of 101 patients were included in this study; diseases progression occurred in 17 patients, 84 patients improved, 6 were transferred to intensive care unit (ICU), and 5 died. The mean time to obtain negative nucleic acid results was 12.5 ± 5.0 days. Multivariate logistic analysis indicated that age (OR, 0.104; p ¼ .002), C-reactive protein (CRP) (OR, 0.093; p < .001) and lymphocyte count (OR, 3.397; p ¼ .022) were risk factors for disease progression. ROC curve analysis revealed that the AUC of age, CRP and lymphocyte count for disease progression were 0.873, 0.911 and 0.817, respectively. Conclusions:Older age increased CRP and decreased lymphocyte count resulted in potential risk factors for COVID-19 progression. This may be helpful in identifying patients whose condition worsens at an early stage. KEYWORDS COVID-19 risk factors outcomeARTICLE HISTORY

Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- A cohort study

“…A history of cardiovascular disease (OR 2.77; p<0.001) and respiratory disease (OR 1.88; p<0.035) showed positive association with mortality in accordance with studies reported in other regions (24,25). Several pathophysiological mechanisms have been proposed that can link increased mortality in COVID-19 infected patients with cardiovascular and respiratory co-morbidities including predisposition to acute respiratory distress syndrome and myocardial injury, although the evidence is still evolving (26).…”

Cardiac manifestations in COVID‐19 patients—A systematic review

“…In a study of 137 patients, 7.3% reported palpitations as one of their symptoms 27 . Several studies have concluded that the prevalence of cardiac arrhythmias is higher in critically ill patients compared to non‐critically ill patients 7,28,29 . Although in most studies the specific cause or types of arrhythmias were not recorded, arrhythmias occurred in around 14% of patients affected with COVID‐19.…”

Novel Use of Home Pulse Oximetry Monitoring in COVID‐19 Patients Discharged From the Emergency Department Identifies Need for Hospitalization

“…Such future studies should consider using known risk factors for poor outcomes in COVID-19 including age, sex, preexisting hypertension, diabetes, chronic lung disease, cardiovascular disease, low albumin, elevated C-reactive protein, and lymphopenia. [19][20][21][22] Finally, we opted to exclude patients who tested negative for COVID-19; however, it should be noted that there is a significant false-negative rate with the current iteration of the RT-PCR test. 23 There may be some utility to providing pulse oximeters to patients with high index of suspicion for COVID-19 who test negative; however, we did not investigate this.…”

“…I n December 2019, a novel coronavirus called SARS-CoV-2 appeared in Wuhan city, Hubei Province, China, and rapidly spread across the rest of the world. This virus causes a disease known as COVID- 19. Most patients with this infection recover after experiencing mild flu-like symptoms, but 20% of patients clinically deteriorate, requiring hospitalization and critical care.…”