tetano
Editor, Senior Moderator
J Med Virol
. 2020 Oct 14.
doi: 10.1002/jmv.26599. Online ahead of print.
Early Clinical Factors Predicting the Development of Critical Disease in Japanese Patients with COVID-19: A Single-Center, Retrospective, Observational Study
Takatoshi Higuchi[SUP] 1 [/SUP], Tsutomu Nishida[SUP] 2 [/SUP], Hiromi Iwahashi[SUP] 1 [/SUP], Osamu Morimura[SUP] 1 [/SUP], Yasushi Otani[SUP] 1 [/SUP], Yukiyoshi Okauchi[SUP] 1 [/SUP], Masaru Yokoe[SUP] 3 [/SUP], Norihiro Suzuki[SUP] 4 [/SUP], Masami Inada[SUP] 2 [/SUP], Kinya Abe[SUP] 1 4 [/SUP]
Affiliations
Abstract
Background: The factors predicting the progression of coronavirus disease 2019 (COVID-19) from mild to moderate to critical are unclear. We retrospectively evaluated risk factors for disease progression in Japanese COVID-19 patients.
Method: Seventy-four patients with laboratory-confirmed COVID-19 were hospitalized in our hospital between February 20, 2020, and June 10, 2020. We excluded asymptomatic, non-Japanese, and pediatric patients. We divided patients into the stable group (SG) and the progression group (PG) (requiring mechanical ventilation). We compared the clinical factors. We established the cutoff values (COVs) for significantly different factors via receiver operating characteristic (ROC) curve analysis and identified risk factors by univariate regression.
Results: We enrolled 57 COVID-19 patients (median age 52 years, 56.1% male). The median time from symptom onset to admission was eight days. Seven patients developed critical disease (PG: 12.2%), two (3.5%) of whom died; 50 had stable disease. Univariate logistic analysis identified an elevated lactate dehydrogenase (LDH) level (COV: 309 U/l), a decreased estimated glomerular filtration rate (eGFR) (COV: 68 ml/min), lymphocytopenia (COV: 980/μl), and statin use as significantly associated with disease progression. However, in the Cox proportional hazards analysis, lymphocytopenia at admission was not significant.
Conclusions: We identified three candidate risk factors for progression to critical COVID-19 in adult Japanese patients: statin use, elevated LDH level, and decreased eGFR. This article is protected by copyright. All rights reserved.
Keywords: COVID‐19; Comorbidity; Critical disease; Disease progression; Japanese patients; Laboratory finding; Risk factors.
. 2020 Oct 14.
doi: 10.1002/jmv.26599. Online ahead of print.
Early Clinical Factors Predicting the Development of Critical Disease in Japanese Patients with COVID-19: A Single-Center, Retrospective, Observational Study
Takatoshi Higuchi[SUP] 1 [/SUP], Tsutomu Nishida[SUP] 2 [/SUP], Hiromi Iwahashi[SUP] 1 [/SUP], Osamu Morimura[SUP] 1 [/SUP], Yasushi Otani[SUP] 1 [/SUP], Yukiyoshi Okauchi[SUP] 1 [/SUP], Masaru Yokoe[SUP] 3 [/SUP], Norihiro Suzuki[SUP] 4 [/SUP], Masami Inada[SUP] 2 [/SUP], Kinya Abe[SUP] 1 4 [/SUP]
Affiliations
- PMID: 33090527
- DOI: 10.1002/jmv.26599
Abstract
Background: The factors predicting the progression of coronavirus disease 2019 (COVID-19) from mild to moderate to critical are unclear. We retrospectively evaluated risk factors for disease progression in Japanese COVID-19 patients.
Method: Seventy-four patients with laboratory-confirmed COVID-19 were hospitalized in our hospital between February 20, 2020, and June 10, 2020. We excluded asymptomatic, non-Japanese, and pediatric patients. We divided patients into the stable group (SG) and the progression group (PG) (requiring mechanical ventilation). We compared the clinical factors. We established the cutoff values (COVs) for significantly different factors via receiver operating characteristic (ROC) curve analysis and identified risk factors by univariate regression.
Results: We enrolled 57 COVID-19 patients (median age 52 years, 56.1% male). The median time from symptom onset to admission was eight days. Seven patients developed critical disease (PG: 12.2%), two (3.5%) of whom died; 50 had stable disease. Univariate logistic analysis identified an elevated lactate dehydrogenase (LDH) level (COV: 309 U/l), a decreased estimated glomerular filtration rate (eGFR) (COV: 68 ml/min), lymphocytopenia (COV: 980/μl), and statin use as significantly associated with disease progression. However, in the Cox proportional hazards analysis, lymphocytopenia at admission was not significant.
Conclusions: We identified three candidate risk factors for progression to critical COVID-19 in adult Japanese patients: statin use, elevated LDH level, and decreased eGFR. This article is protected by copyright. All rights reserved.
Keywords: COVID‐19; Comorbidity; Critical disease; Disease progression; Japanese patients; Laboratory finding; Risk factors.