BMC Infect Dis . characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, China

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BMC Infect Dis


. 2021 Sep 14;21(1):951.
doi: 10.1186/s12879-021-06585-8.
Clinical characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, China


Meng Jin ^{# 1} , Zequn Lu ^{# 2} , Xu Zhang ^{# 3} , Yanan Wang ^{# 4} , Jing Wang ^{# 4} , Yimin Cai ^{# 2} , Kunming Tian ⁵ , Zezhong Xiong ⁴ , Qiang Zhong ⁶ , Xiao Ran ⁶ , Chunguang Yang ⁴ , Xing Zeng ⁴ , Lu Wang ² , Yao Li ² , Shanshan Zhang ² , Tianyi Dong ² , Xinying Yue ² , Heng Li ⁴ , Bo Liu ⁷ , Xin Chen ⁷ , Hongyuan Cui ⁸ , Jirong Qi ⁹ , Haining Fan ¹⁰ , Haixia Li ¹¹ , Xiang-Ping Yang ¹² , Zhiquan Hu ⁴ , Shaogang Wang ⁴ , Jun Xiao ^{# 13} , Ying Wang ^{# 14} , Jianbo Tian ^{# 15} , Zhihua Wang ^{# 16}



Affiliations

• PMID: 34521370
• DOI: 10.1186/s12879-021-06585-8

Abstract

Background: The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted.
Methods: In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020.
Results: Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19.
Conclusions: The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.

Keywords: COVID-19; Death risk; Immune cells subsets; Risk prediction models.