tetano
Editor, Senior Moderator
Clin Microbiol Infect
. 2020 Jun 8;S1198-743X(20)30341-4.
doi: 10.1016/j.cmi.2020.05.041. Online ahead of print.
Risk Factors for Disease Progression in Mild to Moderate COVID-19 Patients- A Multi-Center Observational Study
Yuan Cen[SUP] 1 [/SUP], Xian Chen[SUP] 2 [/SUP], Ye Shen[SUP] 3 [/SUP], Xiao-Hua Zhang[SUP] 4 [/SUP], Yu Lei[SUP] 5 [/SUP], Cheng Xu[SUP] 6 [/SUP], Wen-Rui Jiang[SUP] 7 [/SUP], Hai-Tao Xu[SUP] 8 [/SUP], Yang Chen[SUP] 9 [/SUP], Jie Zhu[SUP] 10 [/SUP], Li-Li Zhang[SUP] 11 [/SUP], Yu-Hui Liu[SUP] 12 [/SUP]
Affiliations
Abstract
Objectives: Since December 2019, patients infected with a novel coronavirus disease (COVID-19) emerged in Wuhan city and rapidly spread globally. The risk for poor outcome dramatically increases once a patient progressed to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in mild to moderate cases of COVID-19.
Methods: We conducted a cohort study which included 1007 mild to moderate cases with COVID-19 from 3 hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients had been followed up for 28 days for observation of disease progression. The endpoint was the progression to a more severe disease stage.
Results: During a follow up of 28 days, 720 patients (71.50%) had recovered or been symptomatically stable, 222 patients (22.05%) had progressed to the severe stage, 22 patients (2.18%) had progressed to the critically ill stage, 43 patients (4.27%) had deceased. Multivariate Cox proportional hazards models identified that increased age (HR 2.56, 95% CI 1.97 to 3.33), male sex (HR 1.79, 95% CI 1.41 to 2.28), presence of hypertension (HR 1.44, 95% CI 1.11 to 1.88), diabetes (HR 1.82, 95% CI 1.35 to 2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38 to 2.93) and coronary artery disease (HR 1.83, 95% CI 1.26 to 2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34 to 0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02 to 2.90), urea nitrogen (HR 1.72, 95% CI 1.21 to 2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26 to 7.21) and D-dimer (HR 2.01, 95% CI 1.12 to 3.58) at baseline were also associated with risk for disease progression.
Conclusions: This study identified a panel of risk factors for disease progression in mild to moderate cases with COVID-19.
Keywords: COVID-19; Comorbidity; Disease progression; Laboratory finding; Risk factors.
. 2020 Jun 8;S1198-743X(20)30341-4.
doi: 10.1016/j.cmi.2020.05.041. Online ahead of print.
Risk Factors for Disease Progression in Mild to Moderate COVID-19 Patients- A Multi-Center Observational Study
Yuan Cen[SUP] 1 [/SUP], Xian Chen[SUP] 2 [/SUP], Ye Shen[SUP] 3 [/SUP], Xiao-Hua Zhang[SUP] 4 [/SUP], Yu Lei[SUP] 5 [/SUP], Cheng Xu[SUP] 6 [/SUP], Wen-Rui Jiang[SUP] 7 [/SUP], Hai-Tao Xu[SUP] 8 [/SUP], Yang Chen[SUP] 9 [/SUP], Jie Zhu[SUP] 10 [/SUP], Li-Li Zhang[SUP] 11 [/SUP], Yu-Hui Liu[SUP] 12 [/SUP]
Affiliations
- PMID: 32526275
- DOI: 10.1016/j.cmi.2020.05.041
Abstract
Objectives: Since December 2019, patients infected with a novel coronavirus disease (COVID-19) emerged in Wuhan city and rapidly spread globally. The risk for poor outcome dramatically increases once a patient progressed to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in mild to moderate cases of COVID-19.
Methods: We conducted a cohort study which included 1007 mild to moderate cases with COVID-19 from 3 hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients had been followed up for 28 days for observation of disease progression. The endpoint was the progression to a more severe disease stage.
Results: During a follow up of 28 days, 720 patients (71.50%) had recovered or been symptomatically stable, 222 patients (22.05%) had progressed to the severe stage, 22 patients (2.18%) had progressed to the critically ill stage, 43 patients (4.27%) had deceased. Multivariate Cox proportional hazards models identified that increased age (HR 2.56, 95% CI 1.97 to 3.33), male sex (HR 1.79, 95% CI 1.41 to 2.28), presence of hypertension (HR 1.44, 95% CI 1.11 to 1.88), diabetes (HR 1.82, 95% CI 1.35 to 2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38 to 2.93) and coronary artery disease (HR 1.83, 95% CI 1.26 to 2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34 to 0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02 to 2.90), urea nitrogen (HR 1.72, 95% CI 1.21 to 2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26 to 7.21) and D-dimer (HR 2.01, 95% CI 1.12 to 3.58) at baseline were also associated with risk for disease progression.
Conclusions: This study identified a panel of risk factors for disease progression in mild to moderate cases with COVID-19.
Keywords: COVID-19; Comorbidity; Disease progression; Laboratory finding; Risk factors.