He Wu, Li Gen, Xu Ke, Yu Bo, Sun Yang, Zhong Kaineng, Zhou Da, Yan Yongcui, Wu Junfang, Wang Dao Wen
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan 430030, China.
Health Commission of Hubei Province, Wuhan 430079, China.
Int J Cardiol Heart Vasc. 2024 Nov 30;56:101574. doi: 10.1016/j.ijcha.2024.101574. eCollection 2025 Feb.
Coronavirus disease (COVID-19) remains one of the most significant factors threatening public health security worldwide. The COVID-19 pandemic has been ongoing for more than 3 years; however, there are few studies on the clinical characteristics and mortality risk factors in patients with COVID-19 based on comprehensive data from multiple centers.
A total of 53,030 patients with confirmed COVID-19 from 138 hospitals in Hubei Province were included in this study. We compared the clinical characteristics between survivors and non-survivors and analyzed the risk factors for in-hospital mortality.
Among the 53,030 patients with COVID-19, 49,320 (93.0 %) were discharged, and 3,710 (7.0 %) died during hospitalization. Cardiovascular disease was the most common comorbidity, followed by endocrine and digestive diseases. Male sex, >65-year-old, and high diastolic blood pressure, a series of abnormal laboratory test indicators and hyponatremia, hypokalemia, acute respiratory distress syndrome, shock, solid tumor, hematological tumor, and insulin use were independent risk factors for in-hospital mortality of patients with COVID-19. In addition, male sex, older age, and higher disease severity were associated with increased mortality in patients with COVID-19.
Patients with early COVID-19 in Hubei Province had high mortality and a high proportion of severe cases and initial comorbidities. Cardiovascular disease was the most common comorbidity in patients with COVID-19. Male sex, older age, comorbidities, and abnormal laboratory data have been identified as independent risk factors for in-hospital mortality in patients with COVID-19. Therefore, there should be an increased focus on patients with COVID-19 with these risk factors.
冠状病毒病（COVID-19）仍然是威胁全球公共卫生安全的最重要因素之一。COVID-19大流行已持续3年多；然而，基于多个中心的综合数据对COVID-19患者的临床特征和死亡风险因素进行的研究较少。
本研究纳入了湖北省138家医院的53030例确诊COVID-19患者。我们比较了幸存者和非幸存者之间的临床特征，并分析了院内死亡的风险因素。
在53030例COVID-19患者中，49320例（93.0%）出院，3710例（7.0%）在住院期间死亡。心血管疾病是最常见的合并症，其次是内分泌和消化系统疾病。男性、年龄>65岁、高舒张压、一系列异常实验室检查指标以及低钠血症、低钾血症、急性呼吸窘迫综合征、休克、实体瘤、血液系统肿瘤和使用胰岛素是COVID-19患者院内死亡的独立危险因素。此外，男性、年龄较大和疾病严重程度较高与COVID-19患者死亡率增加有关。
湖北省早期COVID-19患者死亡率高，重症病例和初始合并症比例高。心血管疾病是COVID-19患者最常见的合并症。男性、年龄较大、合并症和异常实验室数据已被确定为COVID-19患者院内死亡的独立危险因素。因此，应更加关注具有这些危险因素的COVID-19患者。
