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Risk factors for developing severe COVID-19 in China: an analysis of disease surveillance data.
Geng, Meng-Jie; Wang, Li-Ping; Ren, Xiang; Yu, Jian-Xing; Chang, Zhao-Rui; Zheng, Can-Jun; An, Zhi-Jie; Li, Yu; Yang, Xiao-Kun; Zhao, Hong-Ting; Li, Zhong-Jie; He, Guang-Xue; Feng, Zi-Jian.
  • Geng MJ; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Wang LP; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Ren X; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Yu JX; National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Chang ZR; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Zheng CJ; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • An ZJ; National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Li Y; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Yang XK; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Zhao HT; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Li ZJ; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China. lizj@chinacdc.cn.
  • He GX; National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. hegx@chinacdc.cn.
  • Feng ZJ; Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China. fengzj@chinacdc.cn.
Infect Dis Poverty ; 10(1): 48, 2021 Apr 12.
Article in English | MEDLINE | ID: covidwho-1181127
ABSTRACT

BACKGROUND:

COVID-19 has posed an enormous threat to public health around the world. Some severe and critical cases have bad prognoses and high case fatality rates, unraveling risk factors for severe COVID-19 are of significance for predicting and preventing illness progression, and reducing case fatality rates. Our study focused on analyzing characteristics of COVID-19 cases and exploring risk factors for developing severe COVID-19.

METHODS:

The data for this study was disease surveillance data on symptomatic cases of COVID-19 reported from 30 provinces in China between January 19 and March 9, 2020, which included demographics, dates of symptom onset, clinical manifestations at the time of diagnosis, laboratory findings, radiographic findings, underlying disease history, and exposure history. We grouped mild and moderate cases together as non-severe cases and categorized severe and critical cases together as severe cases. We compared characteristics of severe cases and non-severe cases of COVID-19 and explored risk factors for severity.

RESULTS:

The total number of cases were 12 647 with age from less than 1 year old to 99 years old. The severe cases were 1662 (13.1%), the median age of severe cases was 57 years [Inter-quartile range(IQR) 46-68] and the median age of non-severe cases was 43 years (IQR 32-54). The risk factors for severe COVID-19 were being male [adjusted odds ratio (aOR) = 1.3, 95% CI 1.2-1.5]; fever (aOR = 2.3, 95% CI 2.0-2.7), cough (aOR = 1.4, 95% CI 1.2-1.6), fatigue (aOR = 1.3, 95% CI 1.2-1.5), and chronic kidney disease (aOR = 2.5, 95% CI 1.4-4.6), hypertension (aOR = 1.5, 95% CI 1.2-1.8) and diabetes (aOR = 1.96, 95% CI 1.6-2.4). With the increase of age, risk for the severity was gradually higher [20-39 years (aOR = 3.9, 95% CI 1.8-8.4), 40-59 years (aOR = 7.6, 95% CI 3.6-16.3), ≥ 60 years (aOR = 20.4, 95% CI 9.5-43.7)], and longer time from symtem onset to diagnosis [3-5 days (aOR = 1.4, 95% CI 1.2-1.7), 6-8 days (aOR = 1.8, 95% CI 1.5-2.1), ≥ 9 days(aOR = 1.9, 95% CI 1.6-2.3)].

CONCLUSIONS:

Our study showed the risk factors for developing severe COVID-19 with large sample size, which included being male, older age, fever, cough, fatigue, delayed diagnosis, hypertension, diabetes, chronic kidney diasease, early case identification and prompt medical care. Based on these factors, the severity of COVID-19 cases can be predicted. So cases with these risk factors should be paid more attention to prevent severity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Comorbidity / Sex Factors / Age Factors / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Infect Dis Poverty Year: 2021 Document Type: Article Affiliation country: S40249-021-00820-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Comorbidity / Sex Factors / Age Factors / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Infect Dis Poverty Year: 2021 Document Type: Article Affiliation country: S40249-021-00820-9