Risk factors for the critical illness in SARS-CoV-2 infection: a multicenter retrospective cohort study
- PDF / 1,539,681 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 107 Downloads / 219 Views
RESEARCH
Open Access
Risk factors for the critical illness in SARSCoV-2 infection: a multicenter retrospective cohort study Sijing Cheng1,2†, Dingfeng Wu3†, Jie Li4†, Yifeng Zou1†, Yunle Wan1†, Lihan Shen5†, Lixin Zhu1*† , Mang Shi2, Linlin Hou2, Tao Xu6, Na Jiao1, Yichen Li1, Yibo Huang1, Zhipeng Tang7, Mingwei Xu8, Shusong Jiang8, Maokun Li4*, Guangjun Yan4*, Ping Lan1,2* and Ruixin Zhu3* Abstract Background: Prior studies reported that 5 ~ 32% COVID-19 patients were critically ill, a situation that poses great challenge for the management of the patients and ICU resources. We aim to identify independent risk factors to serve as prediction markers for critical illness of SARS-CoV-2 infection. Methods: Fifty-two critical and 200 non-critical SARS-CoV-2 nucleic acid positive patients hospitalized in 15 hospitals outside Wuhan from January 19 to March 6, 2020 were enrolled in this study. Multivariable logistic regression and LASSO logistic regression were performed to identify independent risk factors for critical illness. Results: Age older than 60 years, dyspnea, respiratory rate > 24 breaths per min, leukocytosis > 9.5 × 109/L, neutrophilia > 6.3 × 109/L, lymphopenia < 1.1 × 109/L, neutrophil-to-lymphocyte ratio > 3.53, fibrinogen > 4 g/L, ddimer > 0.55 μg/mL, blood urea nitrogen > 7.1 mM, elevated aspartate transaminase, elevated alanine aminotransferase, total bilirubin > 21 μM, and Sequential Organ Failure Assessment (SOFA) score ≥ 2 were identified as risk factors for critical illness. LASSO logistic regression identified the best combination of risk factors as SOFA score, age, dyspnea, and leukocytosis. The Area Under the Receiver-Operator Curve values for the risk factors in predicting critical illness were 0.921 for SOFA score, 0.776 for age, 0.764 for dyspnea, 0.658 for leukocytosis, and 0.960 for the combination of the four risk factors. Conclusions: Our findings advocate the use of risk factors SOFA score ≥ 2, age > 60, dyspnea and leukocytosis > 9.5 × 109/L on admission, alone or in combination, to determine the optimal management of the patients and health care resources. Keywords: COVID-19, SARS-CoV-2, Intensive care, Ventilator, SOFA score, Age, Dyspnea, Leukocytosis
* Correspondence: [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Lixin Zhu, Maokun Li, Guangjun Yan, Ping Lan and Ruixin Zhu are joint senior authors. † Sijing Cheng, Dingfeng Wu, Jie Li, Yifeng Zou, Yunle Wan, Lihan Shen and Lixin Zhu contributed equally to this work. 1 The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China 4 The Third Clinical Medical College of Yangtze University, Jingzhou Hospital of Traditional Chinese Medicine, Jingzhou 434000, China 3 Putuo People’s Hospital, Department of Bioinformatics, Tongji University, Shanghai 200092, 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 pe
Data Loading...
