Risk factors for disease progression in Japanese patients with COVID-19 with no or mild symptoms on admission

Toshifumi Ninomiya,Yoriko Sato,Hidenobu Arimura,Megumi Nakazawa,Yuko Tsuchiya-Kawano,Kohei Otsubo,Teppei Hoshino,Shun Mizusaki,Mototsugu Shimokawa,Hironori Mikumo,Koji Inoue,Yoichi Nakanishi,Yujiro Uchida,Satoru Kawakami,Yusuke Mori

doi:10.1186/s12879-021-06574-x

Abstract

BackgroundAlthough the risk factors for coronavirus disease 2019 (COVID-19) mortality have been identified, there is limited information about the risk factors for disease progression after hospitalization among Japanese patients with COVID-19 exhibiting no or mild symptoms.MethodsAll 302 consecutive patients who were admitted to our institutions and diagnosed with COVID-19 between March and December 2020 were retrospectively assessed. Ultimately, 210 adult patients exhibiting no or mild symptoms on admission were included in the analysis. They were categorized into the stable (no oxygen needed) and worsened (oxygen needed) groups, and their characteristics and laboratory data were compared.ResultsAmong 210 patients, 49 progressed to a severe disease stage, whereas 161 did not. The mean patient age was 52.14 years, and 126 (60.0%) patients were male. The mean body mass index (BMI) was 23.0 kg/m2, and 71 patients were overweight (BMI ≥ 25 kg/m2). Multivariate logistic analysis showed that old age, overweight, diabetes mellitus (DM), and high serum ferritin levels were independent risk factors for disease progression.ConclusionsClinicians should closely observe patients with COVID-19, especially those with risk factors such as old age, overweight, DM, and high serum ferritin levels, regardless of whether they have no or mild symptoms.

Highlights

The risk factors for coronavirus disease 2019 (COVID-19) mortality have been identified, there is limited information about the risk factors for disease progression after hospitalization among Japanese patients with COVID-19 exhibiting no or mild symptoms
In December 2019, coronavirus disease 2019 (COVID19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, and subsequently spread globally, leading to a pandemic
Little is known about the risk factors for developing severe disease after hospitalization among Japanese patients with COVID-19 exhibiting no or mild symptoms

Summary

Introduction

The risk factors for coronavirus disease 2019 (COVID-19) mortality have been identified, there is limited information about the risk factors for disease progression after hospitalization among Japanese patients with COVID-19 exhibiting no or mild symptoms. In the early stage of the COVID-19 pandemic in Japan, most patients were hospitalized with or without. Little is known about the risk factors for developing severe disease after hospitalization among Japanese patients with COVID-19 exhibiting no or mild symptoms. We have encountered some patients who developed respiratory failure and required oxygen administration or mechanical ventilation after hospitalization despite exhibiting no or mild symptoms on admission. This study aimed to retrospectively evaluate the risk factors for disease progression in patients with COVID‐19 presenting with no or mild symptoms on admission

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