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Outcomes and Prognostic Factors in 70 Non-Survivors and 595 Survivors with COVID-19 in Wuhan, China
24 Pages Posted: 23 Apr 2020
More...Abstract
Background: Since first outbreak of coronavirus disease 2019 (COVID-19) occurred in December 2019, more than one million cases had been reported globally. We aimed to identify the risk factors for in-hospital fatal outcome and severe illness of this disease.
Methods: This is a retrospective, multicentre study, which included all confirmed cases of COVID-19 with definite outcomes (died or discharged) hospitalized between January 1st and March 4th 2020 in Wuhan.
Findings: Of all 665 patients included, 70 died, 595 discharged including 333 mild and 262 severe cases. Underlying comorbidity was more commonly observed among deaths (72.9%) than mild (26.4%) and severe (61.5%) survivors, with hypertension, diabetes and cardiovascular as dominant diseases. Fever and cough were the primary clinical magnifications. Older age (≥ 65 years) (OR=3.174, 95% CI: 1.356-7.755), diabetes (OR=2.540, 95% CI: 0.995-6.377), dyspnea (OR=7.478, 95% CI: 3.031-19.528), respiratory failure (OR=10.528, 95% CI: 4.484-25.829), acute cardiac injury (OR=25.103, 95% CI: 9.057-76.590),and acute respiratory distress syndrome (OR=7.308, 95% CI: 1.501-46.348) were associated with in-hospital fatal outcome. In addition, older age(OR=2.149, 95% CI: 1.424-3.248), diabetes (OR=3.951, 95% CI: 2.077-7.788), cardiovascular disease (OR=3.414, 95% CI: 1.432-8.799), nervous system disease (OR=4.125, 95% CI: 1.252-18.681), dyspnea (OR=31.944, 95% CI: 18.877-92.741), achieving highest in-hospital temperature of >39.0℃ (OR=37.450, 95% CI:7.402-683.403), and longer onset of illness to diagnosis(≥ 9 days) were statistically associated with higher risk of developing severe COVID-19.
Interpretation: The potential risk factors of older age, diabetes, dyspnea, respiratory failure, acute cardiac injury and ARDS could help clinicians to identify patients with poor prognosis at an early stage.
Funding Statement: This study was funded by Beijing Municipal Science and Technology Commission NCP Emergency Project; Hebei Provincial Department of Science and Technology NCP prevention and control emergency scientific research project (Grant no. 20277708D)
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: This study was approved by the ethical review committee at Wuhan Ninth Hospital, and patients consent were exempt by the ethical review committee.
Keywords: 2019 Novel Coronavirus; acute respiratory disease, fatality, prognosis
Suggested Citation: Suggested Citation