COVID-19 with Different Severity: A Multi-center Study of Clinical Features.
Am J Respir Crit Care Med. 2020 Apr 10;:
Authors: Feng Y, Ling Y, Bai T, Xie Y, Huang J, Li J, Xiong W, Yang D, Chen R, Lu F, Lu Y, Liu X, Chen Y, Li X, Li Y, Summah HD, Lin H, Yan J, Zhou M, Lu H, Qu J
RATIONALE: COVID-19 pandemic is now a global health concern.
OBJECTIVES: We compared the clinical characteristics, laboratory examinations, CT images and treatment of COVID-19 patients from three different cities in China.
METHODS: 476 patients were recruited from Jan 1 to Feb 15, 2020 at three hospitals in Wuhan, Shanghai and Anhui. Patients were divided into four groups according to age and into three groups (moderate, severe, and critical group) according to the fifth version of the guidelines issued by the National Health Commission of China on Diagnosis and Treatment of COVID-19.
MEASUREMENTS AND MAIN RESULTS: Compared with moderate group (37.8%), the incidence of comorbidities was higher in severe (46.3%) and critical groups (67.1%). Compared with severe and critical groups, there were more patients taking ACEI/ARB in moderate group. More patients had multiple lung lobe involvement and pleural effusion in the critical group as compared to moderate group. Compared with the moderate group, more patients received antiviral agents within first 4 days than in severe group, and more patients received antibiotics and corticosteriods in critical and severe groups. Patients over 75 years old had significantly lower survival rate than the younger patients.
CONCLUSION: Multiple organ dysfunction and impaired immune function were the typical characteristics of severe and critical patients. There was a significant difference in angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers usage among patients with different severities. Involvement of multiple lung lobes and pleural effusion were associated with the severity of COVID-19. Advanced age (≥75 years) was a risk factor for mortality. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
PMID: 32275452 [PubMed - as supplied by publisher]