Risk factors for severity and mortality in adult COVID 19 inpatients in Wuhan
Abstract Background In December 2019, COVID 19 outbreak occurred in Wuhan. Data on the clinical characteristics and outcomes of patients with severe COVID 19 are limited. Objective The severity on admission, complications, treatment, and outcomes of COVID 19 patients were evaluated. Methods Patients with COVID 19 admitted to Tongji Hospital from January 26, 2020 to February 5, 2020 were retrospectively enrolled and followed up until March 3, 2020. Potential risk factors for severe COVID 19 were analyzed by a multivariable binary logistic model. Cox proportional hazard regression model was used for survival analysis in severe patients. Results We identified 269 (49.1% of 548 patients as severe cases on admission. Elder age, underlying hypertension, high cytokine levels (IL 2R, IL 6, IL 10, and TNF a) and high LDH level were significantly associated with severe COVID 19 on admission. The prevalence of asthma in COVID 19 patients was 0.9% markedly lower than that in the adult population of Wuhan. The estimated mortality was 1.1% in nonsevere patients and 32.5% in severe cases during the average 32 days of follow up period. Survival analysis revealed that male, elder age, leukocytosis, high LDH level, cardiac injury, hyperglycemia, and high dose corticosteroid use were associated with death in patients with severe COVID 19. Conclusions Patients with elder age, hypertension, and high LDH level need careful observation and early intervention to prevent the potential development of severe COVID 19. Severe male patients with heart injury, hyperglycemia, and high dose corticosteroid use may have high risk of death.
Journal of Allergy and Clinical Immunology