The Risk Factors Of Severe Patients With Coronavirus Disease-2019

PurposeCoronavirus Disease-2019(COVID-19)is a novel respiratory infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2(SARS-COV-2).The purpose of the present study was to analyze the clinical characteristics of COVID-19patients and explore the risk factors of severe case with COVID-19,so as to provide help for early identification and timely treatment of severe case with COVID-19.MethodsRetrospective analysis was performed on 432 patients with COVID-19 who were admitted to two tertiary hospitals in Hubei Province of China and treated by Fujian Medical Team aiding Hubei province from January 20,2020 to March 30,2020.According to the severity of the disease,the patients were divided into two groups:307mild-moderate cases were included in the non-severe group and 125 severe-critical ill cases were included in the severe group.Clinical data differences between the two groups were compared,including baseline information,the results of hematological indexes,and radiological finding.SPSS 21.0 software was used for statistical analysis.ResultsA total of 432 patients were enrolled in this study,including 307 patients in the non-severe group(men 155,women 152),the average age was 51.14±16.26 years,and125 patients in the severe group(men 75,women 50),the average age was 59.60±16.65years.The total mortality rate was 5.09%(22/432),and the mortality rate in the severe group was 17.60%(22/125).Patients in the severe group were older and had a higher incidence of comorbidities than those in the non-severe group.Biomarkers of inflammation,liver and kidney function,and myocardial and muscle damage in the severe group were significantly higher than in the non-severe group,while lymphocyte count,hemoglobin,platelet,and albumin levels in the severe group were lower than in the non-severe group.In addition,patients in the severe group also had higher chest computed tomography(CT)score,rate of bilateral pulmonary involvement,and rate of pulmonary consolidation.The results of multivariate Logistic regression analysis showed that combined hypertension[Odds Ratio(OR)3.00,95%Confidence Interval(CI)1.60-5.63,p=0.001],lymphocyte count<1.1×10~9/L(OR 2.09,95%CI 1.23-3.56,p=0.007),alanine aminotransaminase>40U/L(OR 2.19,95%CI 1.12-4.30,p=0.022),creatine kinase>190U/L(OR 2.94,95%CI 1.15-7.50,p=0.024),lactate dehydrogenase>245 U/L(OR 2.30,95%CI 1.25-4.23,p=0.008),chest CT score>10(OR 4.25,95%CI 1.74-10.41,p=0.002),interleukin-2 receptor(IL-2R)>710U/m L(OR9.23,95%CI 2.85-29.86,p=0.000)was positively correlated with the severity of COVID-19 patients,and were independent risk factors for severe COVID-19.ConclusionsThis research shows that hypertension,low lymphocyte count,high alanine aminotransferase,high creatine kinase,high lactate dehydrogenase,high chest CT score,and high IL-2R may be independent risk factors for severe COVID-19,and whether it can help clinicians to early detection of COVID-19 patients with high risk of severe disease need to be more center,more cases and prospective studies to confirm.