ABSTRACT
BACKGROUND: The number of deaths worldwide caused by coronavirus disease (COVID-19) is increasing rapidly. Information about the clinical characteristics of patients with COVID-19 who were not admitted to hospital is limited. Some risk factors of mortality associated with COVID-19 are controversial (eg, smoking). Moreover, the impact of city closure on mortality and admission rates is unknown. OBJECTIVE: The aim of this study was to explore the risk factors of mortality associated with COVID-19 infection among a sample of patients in Wuhan whose conditions were reported on social media. METHODS: We enrolled 599 patients with COVID-19 from 67 hospitals in Wuhan in the study; 117 of the participants (19.5%) were not admitted to hospital. The demographic, epidemiological, clinical, and radiological features of the patients were extracted from their social media posts and coded. Telephone follow-up was conducted 1 month later (between March 15 and 23, 2020) to check the clinical outcomes of the patients and acquire other relevant information. RESULTS: The median age of patients with COVID-19 who died (72 years, IQR 66.5-82.0) was significantly higher than that of patients who recovered (61 years, IQR 53-69, P<.001). We found that lack of admission to hospital (odds ratio [OR] 5.82, 95% CI 3.36-10.1; P<.001), older age (OR 1.08, 95% CI 1.06-1.1; P<.001), diffuse distribution (OR 11.09, 95% CI 0.93-132.9; P=.058), and hypoxemia (odds ratio 2.94, 95% CI 1.32-6.6; P=.009) were associated with increasing odds of death. Smoking was not significantly associated with mortality risk (OR 0.9, 95% CI 0.44-1.85; P=.78). CONCLUSIONS: Older age, diffuse distribution, and hypoxemia are factors that can help clinicians identify patients with COVID-19 who have poor prognosis. Our study suggests that aggregated data from social media can also be comprehensive, immediate, and informative in disease prognosis.
Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , China , Female , Hospitalization , Humans , Infant , Infant, Newborn , Male , Middle Aged , Odds Ratio , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Social Media , Young AdultABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic can have a profound impact on the mental health of patients who survived the illness. However, little is known about the prevalence rate of mental health disorders among hospital discharged COVID-19 patients and its associated factors. A cross-sectional survey of hospital discharged patients was conducted April 11-22, 2020 in Wuhan, China (where the pandemic began). 675 participants completed the survey, including 90 (13.3%) medical staff (physicians and nurses who had been ill). We used Fisher's exact test and multivariable logistic regression methods to explore the risk factors associated with mental health problems (anxiety, depression, and PTSD symptoms associated with COVID-19 hospitalization). Adverse mental health effects of COVID-19 are evident after discharge from the hospital, with sleep difficulties highlighted as a central issue. As we found that perceived discrimination was a central predictor of mental illness, preventing and addressing social stigma associated with COVID-19 may be crucial for improving mental health for recovered patients.