Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single-centre, retrospect
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RESEARCH ARTICLE
Open Access
Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single-centre, retrospective study Ping Yi1†, Xiang Yang2†, Cheng Ding1, Yanfei Chen1, Kaijin Xu1, Qing Ni1, Hong Zhao1, Yongtao Li1, Xuan Zhang1, Jun Liu1, Jifang Sheng1 and Lanjuan Li1*
Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods: A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration. Results: One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36–58] vs [51–70], P = 0.0001); sex (49% vs 77.6%, P = 0.0031); Body Mass Index (BMI) ([21.53–25.51] vs [23.28–27.01], P = 0.0339); hypertension (17.6% vs 57.1%, P < 0.0001); IL-6 ([6.42–30.46] vs [16.2–81.71], P = 0.0001); IL-10 ([2.16–5.82] vs [4.35–9.63], P < 0.0001); T lymphocyte count ([305– 1178] vs [167.5–440], P = 0.0001); B lymphocyte count ([91–213] vs [54.5–163.5], P = 0.0001); white blood cell count ([3.9–7.6] vs [5.5–13.6], P = 0.0002); D2 dimer ([172–836] vs [408–953], P = 0.005), PCT ([0.03–0.07] vs [0.04–0.15], P = 0.0039); CRP ([3.8–27.9] vs [17.3–58.9], P < 0.0001); AST ([16, 29] vs [18, 42], P = 0.0484); artificial liver therapy (2% vs 16.3%, P = 0.0148); and glucocorticoid therapy (64.7% vs 98%, P < 0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. (Continued on next page)
* Correspondence: [email protected] † Ping Yi and Xiang Yang contributed equally to this work. 1 State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou 31003, Zhejiang Province, People’s Republic of China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. I
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