Risk factors for disease progression in mild to moderate COVID-19 patients- a multi-center observational study.
Clin Microbiol Infect. 2020 Jun 08;:
Authors: Cen Y, Chen X, Shen Y, Zhang XH, Lei Y, Xu C, Jiang WR, Xu HT, Chen Y, Zhu J, Zhang LL, Liu YH
OBJECTIVES: Since December 2019, patients infected with a novel coronavirus disease (COVID-19) emerged in Wuhan city and rapidly spread globally. The risk for poor outcome dramatically increases once a patient progressed to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in mild to moderate cases of COVID-19.
METHODS: We conducted a cohort study which included 1007 mild to moderate cases with COVID-19 from 3 hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients had been followed up for 28 days for observation of disease progression. The endpoint was the progression to a more severe disease stage.
RESULTS: During a follow up of 28 days, 720 patients (71.50%) had recovered or been symptomatically stable, 222 patients (22.05%) had progressed to the severe stage, 22 patients (2.18%) had progressed to the critically ill stage, 43 patients (4.27%) had deceased. Multivariate Cox proportional hazards models identified that increased age (HR 2.56, 95% CI 1.97 to 3.33), male sex (HR 1.79, 95% CI 1.41 to 2.28), presence of hypertension (HR 1.44, 95% CI 1.11 to 1.88), diabetes (HR 1.82, 95% CI 1.35 to 2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38 to 2.93) and coronary artery disease (HR 1.83, 95% CI 1.26 to 2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34 to 0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02 to 2.90), urea nitrogen (HR 1.72, 95% CI 1.21 to 2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26 to 7.21) and D-dimer (HR 2.01, 95% CI 1.12 to 3.58) at baseline were also associated with risk for disease progression.
CONCLUSIONS: This study identified a panel of risk factors for disease progression in mild to moderate cases with COVID-19.
PMID: 32526275 [PubMed - as supplied by publisher]