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. 2020 Aug;59(2):168-175.
doi: 10.1016/j.amepre.2020.05.002. Epub 2020 May 27.

Clinical Characteristics, Associated Factors, and Predicting COVID-19 Mortality Risk: A Retrospective Study in Wuhan, China

Caizheng Yu  1 , Qing Lei  2 , Wenkai Li  3 , Xiong Wang  4 , Wei Liu  1 , Xionglin Fan  2 , Wengang Li  5
Affiliations

Clinical Characteristics, Associated Factors, and Predicting COVID-19 Mortality Risk: A Retrospective Study in Wuhan, China

Caizheng Yu et al. Am J Prev Med. 2020 Aug.

Abstract

Introduction: COVID-19 has become a serious global pandemic. This study investigates the clinical characteristics and the risk factors for COVID-19 mortality and establishes a novel scoring system to predict mortality risk in patients with COVID-19.

Methods: A cohort of 1,663 hospitalized patients with COVID-19 in Wuhan, China, of whom 212 died and 1,252 recovered, were included in this study. Demographic, clinical, and laboratory data on admission were collected from electronic medical records between January 14, 2020 and February 28, 2020. Clinical outcomes were collected until March 26, 2020. Multivariable logistic regression was used to explore the association between potential risk factors and COVID-19 mortality. The receiver operating characteristic curve was used to predict COVID-19 mortality risk. All analyses were conducted in April 2020.

Results: Multivariable regression showed that increased odds of COVID-19 mortality was associated with older age (OR=2.15, 95% CI=1.35, 3.43), male sex (OR=1.97, 95% CI=1.29, 2.99), history of diabetes (OR=2.34, 95% CI=1.45, 3.76), lymphopenia (OR=1.59, 95% CI=1.03, 2.46), and increased procalcitonin (OR=3.91, 95% CI=2.22, 6.91, per SD increase) on admission. Spline regression analysis indicated that the correlation between procalcitonin levels and COVID-19 mortality was nonlinear (p=0.0004 for nonlinearity). The area under the receiver operating curve of the COVID-19 mortality risk was 0.765 (95% CI=0.725, 0.805).

Conclusions: The independent risk factors for COVID-19 mortality included older age, male sex, history of diabetes, lymphopenia, and increased procalcitonin, which could help clinicians to identify patients with poor prognosis at an earlier stage. The COVID-19 mortality risk score model may assist clinicians in reducing COVID-19-related mortality by implementing better strategies for more effective use of limited medical resources.

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References

    1. Chen N, Zhou M, Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513. doi: 10.1016/S0140-6736(20)30211-7. - DOI - PMC - PubMed
    1. Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol. 2020;92(4):401–402. doi: 10.1002/jmv.25678. - DOI - PMC - PubMed
    1. Zhu N, Zhang D, Wang W. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed
    1. Tan W, Zhao X, Ma X. Notes from the field: a novel coronavirus genome identified in a cluster of pneumonia cases—Wuhan, China 2019-2020. China CDC Wkly. 2020;2(4):61–62. http://weekly.chinacdc.cn/en/article/ccdcw/2020/4/61 Accessed April 10, 2020. - PMC - PubMed
    1. Zhou P, Yang XL, Wang XG. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–273. doi: 10.1038/s41586-020-2012-7. - DOI - PMC - PubMed

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