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BackgroundManagement of high mortality risk due to significant progression requires prior assessment of time-to-progression. However, few related methods are available for COVID-19 pneumonia. MethodsWe retrospectively enrolled 338 adult patients admitted to one hospital between Jan 11, 2020 to Feb 29, 2020. The final follow-up date was March 8, 2020. We compared characteristics between patients with severe and non-severe outcome, and used multivariate survival analyses to assess the risk of progression to severe conditions. ResultsA total of 76 (31.9%) patients progressed to severe conditions and 3 (0.9%) died. The mean time from hospital admission to severity onset is 3.7 days. Age, body mass index (BMI), fever symptom on admission, co-existing hypertension or diabetes are associated with severe progression. Compared to non-severe group, the severe group already demonstrated, at an early stage, abnormalities in biomarkers indicating organ function, inflammatory responses, blood oxygen and coagulation function. The cohort is characterized with increasing cumulative incidences of severe progression up to 10 days after admission. Competing risks survival model incorporating CT imaging and baseline information showed an improved performance for predicting severity onset (mean time-dependent AUC = 0.880). ConclusionsMultiple predisposition factors can be utilized to assess the risk of progression to severe conditions at an early stage. Multivariate survival models can reasonably analyze the progression risk based on early-stage CT images that would otherwise be misjudged by artificial analysis.
RESUMO
Objective To conduct nutritional risk screening and evaluate the relationship of nutritional risk to complication rate and quality of life in tuberculosis inpatients of Shenzhen. Methods A total of 1 374 patients from tuberculosis department and surgery department in the third people′s hospital of Shenzhen were consecutively enrolled. Data were collected on the nutritional risk screening, complication and quality of life. Results The occurence of nutritional risk at admission of inpatients with tuberculosis among total , younger , elderly patients was 77.7%, 70.9%, 88.9%, respectively. There was a significant increase in the occurrence from admission to 2 weeks in all patients (P < 0.05). On admission and 2 weeks after admission or discharge, the occurence in those patients ≥ 65 years was significantly higher than that in the younger ones (P < 0.05) On the scales of quality of life (SF-36), the scores of physical functioning, role-physical, bodily pain, fatigue and general health were significantly lower than in the patients at risk. Conclusion A large proportion of inpatients of tuberculosis is at nutritional risk and tended to be worsen during the course of admission , which has associated with increased complication rate and lower scores of quality of life.
