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Risk factors for severe COVID-19 in middle-aged patients without comorbidities: a multicentre retrospective study.
Wang, Peng; Sha, Jing; Meng, Mei; Wang, Cuiyan; Yao, Qingchun; Zhang, Zhongfa; Sun, Wenqing; Wang, Xingguang; Qie, Guoqiang; Bai, Xue; Liu, Keke; Chu, Yufeng.
  • Wang P; Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China.
  • Sha J; Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China.
  • Meng M; Department of Critical Care Medicine, Ruijin Hospital, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China.
  • Wang C; Shandong Medical Imaging Research Institute Affiliated To Shandong University, Jinan, P.R. China.
  • Yao Q; Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China.
  • Zhang Z; Jinan Infectious Diseases Hospital, Shandong University, Jinan, P. R. China.
  • Sun W; Department of Intensive Care Unit, Shandong Provincial Chest Hospital, Jinan, P. R. China.
  • Wang X; Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, P. R. China.
  • Qie G; Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China.
  • Bai X; Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China.
  • Liu K; Shandong Academy of Clinical Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, P. R. China.
  • Chu Y; Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China. chunancy@163.com.
J Transl Med ; 18(1): 461, 2020 12 07.
Article in English | MEDLINE | ID: covidwho-963340
ABSTRACT

BACKGROUND:

Information regarding characteristics and risk factors of COVID-19 amongst middle-aged (40-59 years) patients without comorbidities is scarce.

METHODS:

We therefore conducted this multicentre retrospective study and collected data of middle-aged COVID-19 patients without comorbidities at admission from three designated hospitals in China.

RESULTS:

Among 119 middle-aged patients without comorbidities, 18 (15.1%) developed into severe illness and 5 (3.9%) died in hospital. ARDS (26, 21.8%) and elevated D-dimer (36, 31.3%) were the most common complications, while other organ complications were relatively rare. Multivariable regression showed increasing odds of severe illness associated with neutrophil to lymphocyte ratio (NLR, OR, 11.238; 95% CI 1.110-1.382; p < 0.001) and D-dimer greater than 1 µg/ml (OR, 16.079; 95% CI 3.162-81.775; p = 0.001) on admission. The AUCs for the NLR, D-dimer greater than 1 µg/ml and combined NLR and D-dimer index were 0.862 (95% CI, 0.751-0.973), 0.800 (95% CI 0.684-0.915) and 0.916 (95% CI, 0.855-0.977), respectively. SOFA yielded an AUC of 0.750 (95% CI 0.602-0.987). There was significant difference in the AUC between SOFA and combined index (z = 2.574, p = 0.010).

CONCLUSIONS:

More attention should be paid to the monitoring and early treatment of respiratory and coagulation abnormalities in middle-aged COVID-19 patients without comorbidities. In addition, the combined NLR and D-dimer higher than 1 µg/ml index might be a potential and reliable predictor for the incidence of severe illness in this specific patient with COVID-19, which could guide clinicians on early classification and management of patients, thereby relieving the shortage of medical resource. However, it is warranted to validate the reliability of the predictor in larger sample COVID-19 patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Transl Med Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Transl Med Year: 2020 Document Type: Article