tetano
Editor, Senior Moderator
BMC Pulm Med
. 2021 Feb 24;21(1):64.
doi: 10.1186/s12890-021-01413-w.
Elevated glucose level leads to rapid COVID-19 progression and high fatality
Wenjun Wang[SUP] #[/SUP][SUP] 1 2 3 [/SUP], Mingwang Shen[SUP] #[/SUP][SUP] 4 [/SUP], Yusha Tao[SUP] 4 [/SUP], Christopher K Fairley[SUP] 4 5 [/SUP], Qin Zhong[SUP] 1 2 3 [/SUP], Zongren Li[SUP] 1 2 3 [/SUP], Hui Chen[SUP] 6 7 [/SUP], Jason J Ong[SUP] 4 5 [/SUP], Dawei Zhang[SUP] 8 [/SUP], Kai Zhang[SUP] 1 [/SUP], Ning Xing[SUP] 9 [/SUP], Huayuan Guo[SUP] 1 [/SUP], Enqiang Qin[SUP] 8 [/SUP], Xizhou Guan[SUP] 10 [/SUP], Feifei Yang[SUP] 1 [/SUP], Sibing Zhang[SUP] 6 11 [/SUP], Lei Zhang[SUP] 12 13 14 [/SUP], Kunlun He[SUP] 15 16 17 [/SUP]
Affiliations
Abstract
Objectives: We aimed to identify high-risk factors for disease progression and fatality for coronavirus disease 2019 (COVID-19) patients.
Methods: We enrolled 2433 COVID-19 patients and used LASSO regression and multivariable cause-specific Cox proportional hazard models to identify the risk factors for disease progression and fatality.
Results: The median time for progression from mild-to-moderate, moderate-to-severe, severe-to-critical, and critical-to-death were 3.0 (interquartile range: 1.8-5.5), 3.0 (1.0-7.0), 3.0 (1.0-8.0), and 6.5 (4.0-16.3) days, respectively. Among 1,758 mild or moderate patients at admission, 474 (27.0%) progressed to a severe or critical stage. Age above 60 years, elevated levels of blood glucose, respiratory rate, fever, chest tightness, c-reaction protein, lactate dehydrogenase, direct bilirubin, and low albumin and lymphocyte count were significant risk factors for progression. Of 675 severe or critical patients at admission, 41 (6.1%) died. Age above 74 years, elevated levels of blood glucose, fibrinogen and creatine kinase-MB, and low plateleta count were significant risk factors for fatality. Patients with elevated blood glucose level were 58% more likely to progress and 3.22 times more likely to die of COVID-19.
Conclusions: Older age, elevated glucose level, and clinical indicators related to systemic inflammatory responses and multiple organ failures, predict both the disease progression and the fatality of COVID-19 patients.
Keywords: COVID-19; Fatality; Progression; Risk factors.
. 2021 Feb 24;21(1):64.
doi: 10.1186/s12890-021-01413-w.
Elevated glucose level leads to rapid COVID-19 progression and high fatality
Wenjun Wang[SUP] #[/SUP][SUP] 1 2 3 [/SUP], Mingwang Shen[SUP] #[/SUP][SUP] 4 [/SUP], Yusha Tao[SUP] 4 [/SUP], Christopher K Fairley[SUP] 4 5 [/SUP], Qin Zhong[SUP] 1 2 3 [/SUP], Zongren Li[SUP] 1 2 3 [/SUP], Hui Chen[SUP] 6 7 [/SUP], Jason J Ong[SUP] 4 5 [/SUP], Dawei Zhang[SUP] 8 [/SUP], Kai Zhang[SUP] 1 [/SUP], Ning Xing[SUP] 9 [/SUP], Huayuan Guo[SUP] 1 [/SUP], Enqiang Qin[SUP] 8 [/SUP], Xizhou Guan[SUP] 10 [/SUP], Feifei Yang[SUP] 1 [/SUP], Sibing Zhang[SUP] 6 11 [/SUP], Lei Zhang[SUP] 12 13 14 [/SUP], Kunlun He[SUP] 15 16 17 [/SUP]
Affiliations
- PMID: 33627118
- DOI: 10.1186/s12890-021-01413-w
Abstract
Objectives: We aimed to identify high-risk factors for disease progression and fatality for coronavirus disease 2019 (COVID-19) patients.
Methods: We enrolled 2433 COVID-19 patients and used LASSO regression and multivariable cause-specific Cox proportional hazard models to identify the risk factors for disease progression and fatality.
Results: The median time for progression from mild-to-moderate, moderate-to-severe, severe-to-critical, and critical-to-death were 3.0 (interquartile range: 1.8-5.5), 3.0 (1.0-7.0), 3.0 (1.0-8.0), and 6.5 (4.0-16.3) days, respectively. Among 1,758 mild or moderate patients at admission, 474 (27.0%) progressed to a severe or critical stage. Age above 60 years, elevated levels of blood glucose, respiratory rate, fever, chest tightness, c-reaction protein, lactate dehydrogenase, direct bilirubin, and low albumin and lymphocyte count were significant risk factors for progression. Of 675 severe or critical patients at admission, 41 (6.1%) died. Age above 74 years, elevated levels of blood glucose, fibrinogen and creatine kinase-MB, and low plateleta count were significant risk factors for fatality. Patients with elevated blood glucose level were 58% more likely to progress and 3.22 times more likely to die of COVID-19.
Conclusions: Older age, elevated glucose level, and clinical indicators related to systemic inflammatory responses and multiple organ failures, predict both the disease progression and the fatality of COVID-19 patients.
Keywords: COVID-19; Fatality; Progression; Risk factors.