Wuhan Ninth Hospital, Wuhan, China.
Hebei Yiling Pharmaceutical Research Institute, National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, China.
Transbound Emerg Dis. 2021 Nov;68(6):3611-3623. doi: 10.1111/tbed.13969. Epub 2021 Jan 17.
Since the first outbreak of coronavirus disease 2019 (COVID-19) occurred in December 2019, more than 51 million cases had been reported globally. We aimed to identify the risk factors for in-hospital fatal outcome and severe pneumonia of this disease. This is a retrospective, multicentre study, which included all confirmed cases of COVID-19 with definite outcomes (died or discharged) hospitalized between 1 January and 4 March 2020 in Wuhan. Of all 665 patients included, 70 died and 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), dyspnoea (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), dyspnoea (OR = 31.944, 95% CI = 18.877-92.741), achieving highest in-hospital temperature of >39.0°C (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. In conclusion, the potential risk factors forolder age, diabetes, dyspnoea, respiratory failure, acute cardiac injury and acute respiratory distress syndrome could help clinicians to identify patients with poor prognosis at an early stage.
自 2019 年 12 月首次爆发 2019 年冠状病毒病（COVID-19）以来，全球已报告超过 5100 万例病例。我们旨在确定这种疾病院内死亡和重症肺炎的危险因素。这是一项回顾性、多中心研究，包括 2020 年 1 月 1 日至 3 月 4 日期间在武汉住院并明确结局（死亡或出院）的所有确诊 COVID-19 患者。在所有 665 例患者中，70 例死亡，595 例出院（包括 333 例轻症和 262 例重症）。死亡患者中更常见合并症（72.9%），而轻症（26.4%）和重症（61.5%）幸存者中更常见。高血压、糖尿病和心血管疾病是主要疾病。发热和咳嗽是主要的临床体征。年龄较大（≥65 岁）（OR=3.174，95%CI=1.356-7.755）、糖尿病（OR=2.540，95%CI=0.995-6.377）、呼吸困难（OR=7.478，95%CI=3.031-19.528）、呼吸衰竭（OR=10.528，95%CI=4.484-25.829）、急性心脏损伤（OR=25.103，95%CI=9.057-76.590）和急性呼吸窘迫综合征（OR=7.308，95%CI=1.501-46.348）与院内死亡结局相关。此外，年龄较大（OR=2.149，95%CI=1.424-3.248）、糖尿病（OR=3.951，95%CI=2.077-7.788）、心血管疾病（OR=3.414，95%CI=1.432-8.799）、神经系统疾病（OR=4.125，95%CI=1.252-18.681）、呼吸困难（OR=31.944，95%CI=18.877-92.741）、最高住院体温>39.0°C（OR=37.450，95%CI=7.402-683.403）和发病至确诊时间较长（≥9 天）与 COVID-19 重症风险增加具有统计学意义。总之，年龄较大、糖尿病、呼吸困难、呼吸衰竭、急性心脏损伤和急性呼吸窘迫综合征等潜在危险因素有助于临床医生早期识别预后不良的患者。
