Yang Yun, Huang Ziyi, Pei Yongjian, Huang Yongkang, Chen Chen, Zhou Tong
Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, People's Republic of China.
Infect Drug Resist. 2025 Jun 25;18:3117-3125. doi: 10.2147/IDR.S525970. eCollection 2025.
Coronavirus disease-2019 (COVID-19) has high mortality and has caused heavy economic burden worldwide. In this study, we investigated the clinical characteristic and prognostic factors of patients with severe COVID-19. We aimed to identify the severe cases in early stages to improve the prognosis and mortality.
We collected the clinical data of 98 patients with severe COVID-19, who were admitted to the Second Affiliated Hospital of Soochow University (Jiangsu, China) from December 2022 to November 2023. The patients were divided into two groups, namely survivors and non-survivors, based on the outcomes of hospitalization. The risk factors affecting the prognosis of severe COVID-19 patients were identified by univariate analysis and multivariate logistic regression analysis. The predictive value of the individual and combined risk factors for the prognosis of severe COVID-19 was evaluated by the area under the receiver operating characteristic curve (AUROC).
Compared with survivors, non-survivors had higher white blood cell (WBC) count, neutrophil count, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and platelet (PLT) count. Moreover, non-survivors exhibited a higher propensity to develop acute kidney injury (AKI) and receive mechanical ventilation (MV) and continuous renal replacement therapy (CRRT). Multivariate logistic regression analysis showed that WBC count, PLT count, APACHE II score, and MV were independent risk factors affecting the prognosis of severe COVID-19 patients, with AUC values of 0.807, 0.690, 0.761, and 0.751, respectively. The AUC of the combined risk factors was 0.897.
WBC count, PLT count, APACHE II score, and MV were independent risk factors for the poor prognosis of severe COVID-19 patients. High WBC count, PLT count, and APACHE II score, as well as the use of MV, showed good predictive value for the mortality of severe COVID-19 cases, especially when combined.
2019冠状病毒病（COVID-19）死亡率高，已在全球造成沉重经济负担。在本研究中，我们调查了重症COVID-19患者的临床特征和预后因素。我们旨在早期识别重症病例，以改善预后和降低死亡率。
我们收集了2022年12月至2023年11月期间入住苏州大学附属第二医院（中国江苏）的98例重症COVID-19患者的临床资料。根据住院结局将患者分为两组，即存活者和非存活者。通过单因素分析和多因素logistic回归分析确定影响重症COVID-19患者预后的危险因素。通过受试者工作特征曲线下面积（AUROC）评估个体和联合危险因素对重症COVID-19预后的预测价值。
与存活者相比，非存活者的白细胞（WBC）计数、中性粒细胞计数、急性生理与慢性健康状况评分系统II（APACHE II）评分和血小板（PLT）计数更高。此外，非存活者发生急性肾损伤（AKI）、接受机械通气（MV）和连续性肾脏替代治疗（CRRT）的倾向更高。多因素logistic回归分析显示，WBC计数、PLT计数、APACHE II评分和MV是影响重症COVID-19患者预后的独立危险因素，AUC值分别为0.807、0.690、0.761和0.751。联合危险因素的AUC为0.897。
WBC计数、PLT计数、APACHE II评分和MV是重症COVID-19患者预后不良的独立危险因素。高WBC计数、PLT计数和APACHE II评分以及MV的使用对重症COVID-19病例的死亡率具有良好的预测价值，尤其是联合使用时。
