Abstract
BackgroundCoronavirus disease 2019 (COVID-19) has infected more than 4 million people within 4 months. There is an urgent need to properly identify high-risk cases that are more likely to deteriorate even if they present mild diseases on admission.MethodsA multicenter nested case-control study was conducted in four designated hospitals in China enrolling confirmed COVID-19 patients who were mild on admission. Baseline clinical characteristics were compared between patients with stable mild illness (stable mild group) and those who deteriorated from mild to severe illness (progression group).ResultsFrom Jan 17, 2020, to Feb 1, 2020, 85 confirmed COVID-19 patients were enrolled, including 16 in the progression group and 69 in the stable mild group. Compared to stable mild group (n = 69), patients in the progression group (n = 16) were more likely to be older, male, presented with dyspnea, with hypertension, and with higher levels of lactase dehydrogenase and c-reactive protein. In multivariate logistic regression analysis, advanced age (odds ratio [OR], 1.012; 95% confidence interval [CI], 1.020–1.166; P = 0.011) and the higher level of lactase dehydrogenase (OR, 1.012; 95% CI, 1.001–1.024; P = 0.038) were independently associated with exacerbation in mild COVID-19 patients.ConclusionAdvanced age and high LDH level are independent risk factors for exacerbation in mild COVID-19 patients. Among the mild patients, clinicians should pay more attention to the elderly patients or those with high LDH levels.
Highlights
Coronavirus disease 2019 (COVID-19) has infected more than 4 million people within 4 months
We compared the baseline characteristics between the stable mild group and progression group, aiming to assess the potential markers to predict whether the disease will progress or not
The severity or clinical condition of COVID-19 patients was classified into pneumonia, severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis, or septic shock according to the World Health Organization (WHO) guideline [5]
Summary
Coronavirus disease 2019 (COVID-19) has infected more than 4 million people within 4 months. Coronavirus diseases 2019 (COVID-19) is officially a pandemic [1]. Research of clinical characteristics of COVID-19 patients began at January, leading by Huang and his colleagues [3]. They reported that more than half of COVID19 patients developed dyspnea at 8 days following the. Shi et al BMC Medicine (2020) 18:168. In light of these uncertainties, we enrolled patients who were evaluated as mild COVID-19 on admission from a prospective cohort in four hospitals. We compared the baseline characteristics between the stable mild group and progression group, aiming to assess the potential markers to predict whether the disease will progress or not
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