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Risk Factors of Fatal Outcome in Hospitalized Subjects With Coronavirus Disease 2019 From a Nationwide Analysis in China.
Chen, Ruchong; Liang, Wenhua; Jiang, Mei; Guan, Weijie; Zhan, Chen; Wang, Tao; Tang, Chunli; Sang, Ling; Liu, Jiaxing; Ni, Zhengyi; Hu, Yu; Liu, Lei; Shan, Hong; Lei, Chunliang; Peng, Yixiang; Wei, Li; Liu, Yong; Hu, Yahua; Peng, Peng; Wang, Jianming; Liu, Jiyang; Chen, Zhong; Li, Gang; Zheng, Zhijian; Qiu, Shaoqin; Luo, Jie; Ye, Changjiang; Zhu, Shaoyong; Liu, Xiaoqing; Cheng, Linling; Ye, Feng; Zheng, Jinping; Zhang, Nuofu; Li, Yimin; He, Jianxing; Li, Shiyue; Zhong, Nanshan.
  • Chen R; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Liang W; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Jiang M; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Guan W; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Zhan C; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Wang T; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Tang C; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Sang L; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Liu J; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Ni Z; Wuhan Jin-yin tan Hospital, Wuhan, Hubei, China.
  • Hu Y; Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Liu L; Shenzhen Third People's Hospital, Shenzhen, China; The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, China.
  • Shan H; The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.
  • Lei C; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Peng Y; The Central Hospital of Wuhan, Wuhan, Hubei, China.
  • Wei L; Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, Hubei, China.
  • Liu Y; Chengdu Public Health Clinical Medical Center, Chengdu, Sichuan, China.
  • Hu Y; Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, Hubei, China.
  • Peng P; Wuhan Pulmonary Hospital, Wuhan, Hubei, China.
  • Wang J; Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China.
  • Liu J; The First Hospital of Changsha, Changsha, Hunan, China.
  • Chen Z; The Third People's Hospital of Hainan Province, Sanya, Hainan, China.
  • Li G; Huanggang Central Hospital, Huanggang, Hubei, China.
  • Zheng Z; Wenling First People's Hospital, Wenling, Zhejiang, China.
  • Qiu S; The Third People's Hospital of Yichang, Yichang, Hubei Province, China.
  • Luo J; Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, China.
  • Ye C; Xiantao First People's Hospital, Xiantao, China.
  • Zhu S; The People's Hospital of Huangpi District, Wuhan, China.
  • Liu X; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Cheng L; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Ye F; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Zheng J; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Zhang N; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Li Y; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • He J; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Li S; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. Electronic address: lishiyue@188.com.
  • Zhong N; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Chest ; 158(1): 97-105, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-980155
ABSTRACT

BACKGROUND:

The novel coronavirus disease 2019 (COVID-19) has become a global health emergency. The cumulative number of new confirmed cases and deaths are still increasing out of China. Independent predicted factors associated with fatal outcomes remain uncertain. RESEARCH QUESTION The goal of the current study was to investigate the potential risk factors associated with fatal outcomes from COVID-19 through a multivariate Cox regression analysis and a nomogram model. STUDY DESIGN AND

METHODS:

A retrospective cohort of 1,590 hospitalized patients with COVID-19 throughout China was established. The prognostic effects of variables, including clinical features and laboratory findings, were analyzed by using Kaplan-Meier methods and a Cox proportional hazards model. A prognostic nomogram was formulated to predict the survival of patients with COVID-19.

RESULTS:

In this nationwide cohort, nonsurvivors included a higher incidence of elderly people and subjects with coexisting chronic illness, dyspnea, and laboratory abnormalities on admission compared with survivors. Multivariate Cox regression analysis showed that age ≥ 75 years (hazard ratio [HR], 7.86; 95% CI, 2.44-25.35), age between 65 and 74 years (HR, 3.43; 95% CI, 1.24-9.5), coronary heart disease (HR, 4.28; 95% CI, 1.14-16.13), cerebrovascular disease (HR, 3.1; 95% CI, 1.07-8.94), dyspnea (HR, 3.96; 95% CI, 1.42-11), procalcitonin level > 0.5 ng/mL (HR, 8.72; 95% CI, 3.42-22.28), and aspartate aminotransferase level > 40 U/L (HR, 2.2; 95% CI, 1.1-6.73) were independent risk factors associated with fatal outcome. A nomogram was established based on the results of multivariate analysis. The internal bootstrap resampling approach suggested the nomogram has sufficient discriminatory power with a C-index of 0.91 (95% CI, 0.85-0.97). The calibration plots also showed good consistency between the prediction and the observation.

INTERPRETATION:

The proposed nomogram accurately predicted clinical outcomes of patients with COVID-19 based on individual characteristics. Earlier identification, more intensive surveillance, and appropriate therapy should be considered in patients at high risk.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Aspartato Aminotransferasas / Enfermedades Cardiovasculares / Infecciones por Coronavirus / Disnea / Pandemias / Polipéptido alfa Relacionado con Calcitonina Tipo de estudio: Estudio de cohorte / Estudios diagnósticos / Estudio observacional / Estudio pronóstico Límite: Anciano / Femenino / Humanos / Masculino País/Región como asunto: Asia Idioma: Inglés Revista: Chest Año: 2020 Tipo del documento: Artículo País de afiliación: J.chest.2020.04.010

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Aspartato Aminotransferasas / Enfermedades Cardiovasculares / Infecciones por Coronavirus / Disnea / Pandemias / Polipéptido alfa Relacionado con Calcitonina Tipo de estudio: Estudio de cohorte / Estudios diagnósticos / Estudio observacional / Estudio pronóstico Límite: Anciano / Femenino / Humanos / Masculino País/Región como asunto: Asia Idioma: Inglés Revista: Chest Año: 2020 Tipo del documento: Artículo País de afiliación: J.chest.2020.04.010