Association Between Clinical Manifestations and Prognosis in Patients with COVID-19

• Published in: Clinical therapeutics Vol. 42; no. 6; pp. 964 - 972
• Main Authors: Yu, Tao, Cai, Shaohang, Zheng, Zhidan, Cai, Xuejuan, Liu, Yuanyuan, Yin, Sichun, Peng, Jie, Xu, Xuwen
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2020; Elsevier Limited; The Authors. Published by Elsevier Inc
• Subjects: 2019-nCoV; Acute respiratory distress syndrome; Aged; Betacoronavirus - pathogenicity; Blood pressure; Body mass; Body mass index; Body size; Clinical outcomes; Computed tomography; Coronaviridae; Coronavirus Infections - blood; Coronavirus Infections - diagnosis; Coronavirus Infections - mortality; Coronavirus Infections - physiopathology; Coronaviruses; COVID-19; Cross-Sectional Studies; Diagnostic systems; Fever; Health risks; Health services; Humans; Hypertension - blood; Hypertension - mortality; Hypertension - physiopathology; Infections; Infectious diseases; L-Lactate dehydrogenase; L-Lactate Dehydrogenase - blood; Laboratories; Lactate dehydrogenase; Lactic acid; Lymphocytes; Medical imaging; Medical prognosis; Medical treatment; Mercury; Middle Aged; Multivariate analysis; Original Research; Oxygen; Oxygenation; Pandemics; Partial pressure; Pathogenesis; Patients; Pneumonia; Pneumonia, Viral - blood; Pneumonia, Viral - diagnosis; Pneumonia, Viral - mortality; Pneumonia, Viral - physiopathology; Polymerase chain reaction; Prognosis; Proteins; Respiratory distress syndrome; Risk analysis; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome; Target detection; Tobacco; Tobacco smoking; Treatment Outcome; Viral diseases; Viruses; China; Acute respiratory distress syndrome; COVID-19; Pneumonia; 2019-nCoV; Risk factors
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/j.clinthera.2020.04.009

The purpose of this study was to determine the risk factors associated with pneumonia, acute respiratory distress syndrome (ARDS), and clinical outcome among patients with novel coronavirus disease 2019 (COVID-19). This was a cross-sectional multicenter clinical study. A total of 95 patients infected with COVID-19 were enrolled. The COVID-19 diagnostic standard was polymerase chain reaction detection of target genes of 2019 novel coronavirus (2019-nCoV). Clinical, laboratory, and radiologic results, as well as treatment outcome data, were obtained. ARDS was defined as an oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) ≤300 mm Hg. Multivariate analysis showed that older age (odds ratio [OR], 1.078; p = 0.008) and high body mass index (OR, 1.327; p = 0.024) were independent risk factors associated with patients with pneumonia. For patients with ARDS, multivariate analysis showed that only high systolic blood pressure (OR, 1.046; p = 0.025) and high lactate dehydrogenase level (OR, 1.010; p = 0.021) were independent risk factors associated with ARDS. A total of 70 patients underwent CT imaging repeatedly after treatment. Patients were divided in a disease exacerbation group (n = 19) and a disease relief group (n = 51). High body mass index (OR, 1.285; p = 0.017) and tobacco smoking (OR, 16.13; p = 0.032) were independent risk factors associated with disease exacerbation after treatment. These study results help in the risk stratification of patients with 2019-nCoV infection. Patients with risk factors should be given timely intervention to avoid disease progression. •Older age and high BMI were independent risk factors associated with patients with pneumonia infected with 2019-nCoV.•High SBP level and high LDH level were independent risk factors associated with ARDS among patients with COVID-19.•High BMI and tobacco smoking were independent risk factors associated with pneumonia exacerbation after treatment.