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中国武汉 COVID-19 患者疾病严重程度、无改善和死亡率的危险因素。

Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China.

机构信息

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.

Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.

出版信息

Clin Microbiol Infect. 2020 Jun;26(6):767-772. doi: 10.1016/j.cmi.2020.04.012. Epub 2020 Apr 15.

Abstract

OBJECTIVE

In December 2019, coronavirus disease (COVID-19) emerged in Wuhan. However, the characteristics and risk factors associated with disease severity, unimprovement and mortality are unclear and our objective is to throw some light on these.

METHODS

All consecutive patients diagnosed with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 11 to February 6, 2020, were enrolled in this retrospective cohort study.

RESULTS

A total of 663 COVID-19 patients were included in this study. Among these, 247 (37.3%) had at least one kind of chronic disease; 0.5% of the patients (n = 3) were diagnosed with mild COVID-19, while 37.8% (251/663), 47.5% (315/663), and 14.2% (94/663) were in moderate, severe, and critical conditions, respectively. In our hospital, during follow-up 251 of 663 patients (37.9%) improved and 25 patients died, a mortality rate of 3.77%. Older patients (>60 years old) and those with chronic diseases were prone to have a severe to critical COVID-19 condition, to show unimprovement, and to die (p <0.001, <0.001). Multivariate logistic regression analysis identified being male (OR = 0.486, 95%CI 0.311-0.758; p 0.001), having a severe COVID-19 condition (OR = 0.129, 95%CI 0.082-0.201; p <0.001), expectoration (OR = 1.796, 95%CI 1.062-3.036; p 0.029), muscle ache (OR = 0.309, 95%CI 0.153-0.626; p 0.001), and decreased albumin (OR = 1.929, 95%CI 1.199-3.104; p 0.007) as being associated with unimprovement in COVID-19 patients.

CONCLUSION

Male sex, a severe COVID-19 condition, expectoration, muscle ache, and decreased albumin were independent risk factors which influence the improvement of COVID-19 patients.

摘要

目的

2019 年 12 月,冠状病毒病(COVID-19)在武汉出现。然而,与疾病严重程度、无改善和死亡率相关的特征和危险因素尚不清楚,我们的目的是对此进行一些阐述。

方法

本回顾性队列研究纳入了 2020 年 1 月 11 日至 2 月 6 日期间因 COVID-19 入住武汉大学人民医院的所有连续患者。

结果

本研究共纳入 663 例 COVID-19 患者。其中,247 例(37.3%)至少有一种慢性病;3 例(0.5%)患者被诊断为轻度 COVID-19,而 37.8%(251/663)、47.5%(315/663)和 14.2%(94/663)分别为中度、重度和危急情况。在我院,663 例患者中,251 例(37.9%)在随访期间好转,25 例死亡,死亡率为 3.77%。年龄较大(>60 岁)和有慢性病的患者更容易出现严重至危急的 COVID-19 病情、无改善和死亡(p<0.001,<0.001)。多变量逻辑回归分析发现男性(OR=0.486,95%CI 0.311-0.758;p<0.001)、重度 COVID-19 状况(OR=0.129,95%CI 0.082-0.201;p<0.001)、咳痰(OR=1.796,95%CI 1.062-3.036;p=0.029)、肌肉酸痛(OR=0.309,95%CI 0.153-0.626;p<0.001)和白蛋白降低(OR=1.929,95%CI 1.199-3.104;p=0.007)与 COVID-19 患者的无改善相关。

结论

男性、重度 COVID-19 状况、咳痰、肌肉酸痛和白蛋白降低是影响 COVID-19 患者改善的独立危险因素。

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