From the, State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Laboratory Medicine, The First People's Hospital of Yancheng City, Yancheng, China.
J Intern Med. 2020 Jul;288(1):128-138. doi: 10.1111/joim.13063. Epub 2020 Apr 20.
At present, the severity of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a focal point.
To assess the factors associated with severity and prognosis of patients infected with SARS-CoV-2, we retrospectively investigated the clinical, imaging and laboratory characteristics of confirmed 280 cases of novel coronavirus disease (COVID-19) from 20 January to 20 February 2020.
The median age of patients in the mild group was 37.55 years, whilst that in the severe group was 63.04 years. The proportion of patients aged over 65 years in the severe group was significantly higher than that of the mild group (59.04% vs. 10.15%, P < 0.05). 85.54% of severe patients had diabetes or cardiovascular diseases, which was significantly higher than that of the mild group (51.81% vs. 7.11%, P = 0.025; 33.73% vs. 3.05%, P = 0.042). Patients in the mild group experienced earlier initiation of antiviral treatment (1.19 ± 0.45 vs. 2.65 ± 1.06 days in the severe group, P < 0.001). Our study showed that comorbidity, time from illness onset to antiviral treatment and age >=65 were three major risk factors for COVID-19 progression, whilst comorbidity and time from illness onset to antiviral treatment were two major risk factors for COVID-19 recovery.
The elderly and patients with underlying diseases are more likely to experience a severe progression of COVID-19. It is recommended that timely antiviral treatment should be initiated to slow the disease progression and improve the prognosis.
目前，严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患者的严重程度一直是关注焦点。
为评估与 SARS-CoV-2 感染患者严重程度和预后相关的因素，我们回顾性调查了 2020 年 1 月 20 日至 2 月 20 日期间确诊的 280 例新型冠状病毒病（COVID-19）患者的临床、影像学和实验室特征。
轻症组患者的中位年龄为 37.55 岁，而重症组为 63.04 岁。重症组中年龄大于 65 岁的患者比例明显高于轻症组（59.04%比 10.15%，P<0.05）。85.54%的重症患者患有糖尿病或心血管疾病，明显高于轻症组（51.81%比 7.11%，P=0.025；33.73%比 3.05%，P=0.042）。轻症组患者更早开始抗病毒治疗（1.19±0.45 天比重症组的 2.65±1.06 天，P<0.001）。我们的研究表明，合并症、从发病到抗病毒治疗的时间以及年龄>=65 岁是 COVID-19 进展的三个主要危险因素，而合并症和从发病到抗病毒治疗的时间是 COVID-19 恢复的两个主要危险因素。
老年人和有基础疾病的患者更有可能经历 COVID-19 的严重进展。建议及时启动抗病毒治疗，以减缓疾病进展并改善预后。
