Qingchun Yao1, Peng Wang1, Xingguang Wang2, Guoqiang Qie1, Mei Meng3, Xiwen Tong4, Xue Bai1, Min Ding1, Weiming Liu1, Keke Liu5, Yufeng Chu6. 1. Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China 2. Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China 3. Department of Critical Care Medicine, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China 4. Department of Cardio‑Thoracic Surgery, Huanggang Central Hospital, Huanggang, China 5. Shandong Academy of Clinical Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China 6. Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China. chunancy@163.com
Abstract
INTRODUCTION: Coronavirus disease 2019 (COVID‑19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection spread worldwide. OBJECTIVES: The aim of the study was to identify the clinical characteristics and risk factors associated with severe incidence of SARS ‑CoV‑2 infection. PATIENTS AND METHODS: All adult patients (median [IQR] age, 52 [37-58] years) consecutively admitted to the Dabieshan Medical Center from January 30, 2020 to February 11, 2020 were collected and reviewed. Only patients diagnosed with COVID‑19 according to the World Health Organization interim guidance were included in this retrospective cohort study. RESULTS: A total of 108 patients with COVID‑19 were retrospectively analyzed. Twenty‑five patients (23.1%) developed severe disease, and of those 12 patients (48%) died. Advanced age, comorbidities (most commonly hypertension), higher blood leukocyte count, neutrophil count, higher C‑reactive protein level, D‑dimer level, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score were associated with greater risk of COVID‑19, and so were lower lymphocyte count and albumin level. Multivariable regress ion showed increasing odds of severe COVID‑19 associated with higher SOFA score (odds ratio [OR], 2.45; 95% CI, 1.302-4.608; P = 0.005), and lymphocyte count less than 0.8 × 109/l (OR, 9.017; 95% CI, 2.808-28.857; P <0.001) on admission. Higher SOFA score (OR, 2.402; 95% CI, 1.313-4.395; P = 0.004) on admission was identified as risk factor for in‑hospital death. CONCLUSIONS: Lymphocytopenia and a higher SOFA score on admission could help clinicians to identify patients at high risk for developing severe COVID‑19. More related studies are needed in the future.
INTRODUCTION: Coronavirus disease 2019 (COVID‑19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection spread worldwide. OBJECTIVES: The aim of the study was to identify the clinical characteristics and risk factors associated with severe incidence of SARS ‑CoV‑2 infection. PATIENTS AND METHODS: All adult patients (median [IQR] age, 52 [37-58] years) consecutively admitted to the Dabieshan Medical Center from January 30, 2020 to February 11, 2020 were collected and reviewed. Only patients diagnosed with COVID‑19 according to the World Health Organization interim guidance were included in this retrospective cohort study. RESULTS: A total of 108 patients with COVID‑19 were retrospectively analyzed. Twenty‑five patients (23.1%) developed severe disease, and of those 12 patients (48%) died. Advanced age, comorbidities (most commonly hypertension), higher blood leukocyte count, neutrophil count, higher C‑reactive protein level, D‑dimer level, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score were associated with greater risk of COVID‑19, and so were lower lymphocyte count and albumin level. Multivariable regress ion showed increasing odds of severe COVID‑19 associated with higher SOFA score (odds ratio [OR], 2.45; 95% CI, 1.302-4.608; P = 0.005), and lymphocyte count less than 0.8 × 109/l (OR, 9.017; 95% CI, 2.808-28.857; P <0.001) on admission. Higher SOFA score (OR, 2.402; 95% CI, 1.313-4.395; P = 0.004) on admission was identified as risk factor for in‑hospital death. CONCLUSIONS: Lymphocytopenia and a higher SOFA score on admission could help clinicians to identify patients at high risk for developing severe COVID‑19. More related studies are needed in the future.
Authors: Kapil G Zirpe; Anand M Tiwari; Sushma K Gurav; Abhijit M Deshmukh; Prasad B Suryawanshi; Prajkta P Wankhede; Upendrakumar S Kapse; Abhaya P Bhoyar; Afroz Z Khan; Ria V Malhotra; Pranoti H Kusalkar; Kaustubh J Chavan; Seema A Naik; Rahul B Bhalke; Ninad N Bhosale; Sonika V Makhija; Venkata N Kuchimanchi; Amol S Jadhav; Kedar R Deshmukh; Gaurav S Kulkarni Journal: Indian J Crit Care Med Date: 2021-05