Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China.
School of Public Health and Management, Hubei University of Medicine, Shiyan, China.
Int J Epidemiol. 2021 Jan 23;49(6):1940-1950. doi: 10.1093/ije/dyaa180.
The new coronavirus (COVID-19) rapidly resulted in a pandemic. We report the characteristics of patients with severe or critical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Wuhan city, China, and the risk factors related to infection severity and death.
We extracted the demographic and clinical data of 7283 patients with severe COVID-19 infection from designated Wuhan hospitals as of 25 February 2020. Factors associated with COVID-19 critical illness and mortality were analysed using logistic- and Cox-regression analyses.
We studied 6269 patients with severe COVID-19 illness and 1014 critically ill patients. The median (IQR) age was 64 (53-71) years; 51.2% were male, 38.9% were retirees and 7.4% had self-reported histories of chronic disease. Up to the end of the study, 1180 patients (16.2%) recovered and were discharged, 649 (8.9%) died and the remainder were still receiving treatment. The number of daily confirmed critical cases peaked between 23 January and 1 February 2020. Patients with advanced age [odds ratio (OR), 1.03; 95% confidence intervals (CIs), 1.03-1.04], male sex (OR, 1.57; 95% CI, 1.33-1.86) and pre-existing diabetes (OR, 2.11), hypertension (OR, 2.72), cardiovascular disease (OR, 2.15) or respiratory disease (OR, 3.50) were more likely to be critically ill. Compared with those who recovered and were discharged, patients who died were older [hazard ratio (HR), 1.04; 95% CI, 1.03-1.05], more likely to be male (HR, 1.74; 95% CI, 1.44-2.11) and more likely to have hypertension (HR, 5.58), cardiovascular disease (HR, 1.83) or diabetes (HR, 1.67).
Advanced age, male sex and a history of chronic disease were associated with COVID-19 critical illness and death. Identifying these risk factors could help in the clinical monitoring of susceptible populations.
新型冠状病毒（COVID-19）迅速引发了大流行。我们报告了中国武汉市严重或危重严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患者的特征，以及与感染严重程度和死亡相关的危险因素。
截至 2020 年 2 月 25 日，我们从指定的武汉医院提取了 7283 例严重 COVID-19 感染患者的人口统计学和临床数据。使用逻辑回归和 Cox 回归分析来分析与 COVID-19 重症和死亡相关的因素。
我们研究了 6269 例严重 COVID-19 疾病患者和 1014 例危重症患者。中位（IQR）年龄为 64（53-71）岁；51.2%为男性，38.9%为退休人员，7.4%有自我报告的慢性病史。截至研究结束时，1180 例（16.2%）患者康复出院，649 例（8.9%）死亡，其余仍在接受治疗。每日确诊重症病例数在 2020 年 1 月 23 日至 2 月 1 日期间达到峰值。年龄较大的患者[比值比（OR），1.03；95%置信区间（CI），1.03-1.04]、男性（OR，1.57；95%CI，1.33-1.86）和患有糖尿病（OR，2.11）、高血压（OR，2.72）、心血管疾病（OR，2.15）或呼吸系统疾病（OR，3.50）的患者更容易出现重症。与康复出院的患者相比，死亡患者年龄更大[风险比（HR），1.04；95%CI，1.03-1.05]，更可能是男性（HR，1.74；95%CI，1.44-2.11），并且更可能患有高血压（HR，5.58）、心血管疾病（HR，1.83）或糖尿病（HR，1.67）。
年龄较大、男性和慢性病史与 COVID-19 重症和死亡相关。识别这些危险因素有助于对易感人群进行临床监测。
