Clinical Characteristics and Risk Factors of Poor Prognosis in 83 Cases of Coronavirus Disease 2019

Abstract

Objective Since December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan city and rapidly spread throughout the world. The clinical characteristics of patients with COVID-19 have been reported, but risk factors for prognosis have not been well described.Methods A total of 83 patients with COVID-19 were included in this retrospective study. All cases were divided into severe and nonsevere groups according to the severity of the disease. The primary composite endpoint was admission to an intensive care unit (ICU), use of mechanical ventilation or high-flow oxygen, or death. We used univariable and multivariable logistic regression methods to explore the risk factors associated with the primary composite endpoint.ResultsThe median age of patients was 46 years; a total of 48.2% of the patients were male. Of these patients, 17 were in the severe group (20.5%), and 66 were in the nonsevere group (79.5%).ln the severe group, the proportions of basic diseases, including hypertension, diabetes, and malignant tumors, were significantly higher than those in the nonsevere group(all P<0.05), and patients in the severe group were significantly older than those in the nonsevere group (P<0.05).The primary composite endpoint occurred in 13(15.7%) patients, including 10(12.0%) who underwent mechanical ventilation, 3(3.6%) who were treated with high-flow oxygen, 5(6.0%) who were admitted to the ICU,and 5(6.0%) who died. Multivariable regression showed that an increase in high-sensitivity C-reactive protein (1.063,1.02-1.108;P=0.004) or having diabetes (735.985,7.111-8444.318;P=0.002) was an independent risk factor for COVID-19 patients with poor prognosis; however,higher hemoglobin was associated with lower odds of poor prognosis(0.912, 0.856-0.97;P=0.004).CondusionMore than 20% ofpatients with COVID-19 developed severe conditions with a poor prognosis. The potential risk factors of high-sensitivity C-reactive protein, diabetes andlow hemoglobin content could help clinicians identify COVID-19 patients with poor prognosis on admission.