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Clinical characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, China.
Jin, Meng; Lu, Zequn; Zhang, Xu; Wang, Yanan; Wang, Jing; Cai, Yimin; Tian, Kunming; Xiong, Zezhong; Zhong, Qiang; Ran, Xiao; Yang, Chunguang; Zeng, Xing; Wang, Lu; Li, Yao; Zhang, Shanshan; Dong, Tianyi; Yue, Xinying; Li, Heng; Liu, Bo; Chen, Xin; Cui, Hongyuan; Qi, Jirong; Fan, Haining; Li, Haixia; Yang, Xiang-Ping; Hu, Zhiquan; Wang, Shaogang; Xiao, Jun; Wang, Ying; Tian, Jianbo; Wang, Zhihua.
  • Jin M; Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
  • Lu Z; Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, No. 13, Hangkong Rd, Wuhan, 430030, Hubei, China.
  • Zhang X; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Wang Y; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Wang J; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Cai Y; Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, No. 13, Hangkong Rd, Wuhan, 430030, Hubei, China.
  • Tian K; Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Xiong Z; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Zhong Q; Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Ran X; Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Yang C; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Zeng X; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Wang L; Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, No. 13, Hangkong Rd, Wuhan, 430030, Hubei, China.
  • Li Y; Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, No. 13, Hangkong Rd, Wuhan, 430030, Hubei, China.
  • Zhang S; Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, No. 13, Hangkong Rd, Wuhan, 430030, Hubei, China.
  • Dong T; Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, No. 13, Hangkong Rd, Wuhan, 430030, Hubei, China.
  • Yue X; Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, No. 13, Hangkong Rd, Wuhan, 430030, Hubei, China.
  • Li H; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Liu B; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Chen X; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Cui H; Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
  • Qi J; Department of Cardiothoracic Surgery, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.
  • Fan H; Department of General Surgery, Qinghai University Affiliated Hospital, Xining, Qinghai, China.
  • Li H; Computer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Yang XP; Department of Immunology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Hu Z; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Wang S; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China.
  • Xiao J; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China. junxiao_hust@163.com.
  • Wang Y; Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, China. wangyingxiehe@163.com.
  • Tian J; School of Health Sciences, Wuhan University, Wuhan, 430071, China. tianjb@whu.edu.cn.
  • Wang Z; Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Ave, Wuhan, 430030, Hubei, China. zhwang_hust@hotmail.com.
BMC Infect Dis ; 21(1): 951, 2021 Sep 14.
Article in English | MEDLINE | ID: covidwho-1412707
ABSTRACT

BACKGROUND:

The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted.

METHODS:

In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020.

RESULTS:

Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19.

CONCLUSIONS:

The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sepsis / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06585-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sepsis / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06585-8