scholarly journals Risk Factors and clinical features of deterioration of COVID-19 Patients in Zhejiang, China: a single-centered, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Artificial Liver ◽  
Low Doses ◽  
Blood Cell Count ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract BackgroundA severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection swept through Wuhan and spread across China and overseas from December 2019. To identify predictors associated with disease progression, we evaluate clinical risk factors of exacerbation of SARS-CoV2 infection. Methoda retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019) diagnosed hospitalized cases between January 19, 2019 and February 19, 2020 in Zhejiang, China. We systematically analyzed the clinical characteristics of the patients and predictors of clinical deterioration.Result100 patients with COVID-19 were included, with median age of 54 years. Among them, 49 cases (49%) were severe and critical cases. Age (P=0.0001), gender (P=0.0031), BMI (P=0.0339), hypertension (P<0.0001), IL6 (P=0.0001), IL10 (P<0.0001), T lymphocyte count (P=0.0001), B lymphocyte count (P=0.0001), White blood cell count (P=0.0002), d2 dimer (P=0.005), PCT (P=0.0039), CRP (P<0.0001), AST (P=0.0484) and artificial liver therapy (P=0.0148), glucocorticoid therapy (P<0.0001) were associated with the severity of the disease. Age and overweigh were independent risk factors for disease severity. ConclusionDeterioration among covid-19 infected patients occurred rapidly after hospital admission, it is necessary to pay attention to these patients. In our cohort, we found that several factors resulted in increased severity. Among these factors, Early detection and reversal of these indicators may reduce the progression of the disease. In addition, early treatment with low doses of glucocorticoids and necessary liver therapy may help reduce mortality in critically ill patients.

scholarly journals Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Blood Cell Count ◽  
Single Centre ◽  
Multiple Factors ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection.MethodsA retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.ResultsOne hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); Body Mass Index (BMI ) ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity.ConclusionDeterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, Oxygen support, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.

scholarly journals Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single-centre, retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
B Lymphocyte ◽  
Artificial Liver ◽  
Blood Cell Count ◽  
Single Centre ◽  
Multiple Factors ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration. Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36–58] vs [51–70], P = 0.0001); sex (49% vs 77.6%, P = 0.0031); Body Mass Index (BMI) ([21.53–25.51] vs [23.28–27.01], P = 0.0339); hypertension (17.6% vs 57.1%, P < 0.0001); IL-6 ([6.42–30.46] vs [16.2–81.71], P = 0.0001); IL-10 ([2.16–5.82] vs [4.35–9.63], P < 0.0001); T lymphocyte count ([305–1178] vs [167.5–440], P = 0.0001); B lymphocyte count ([91–213] vs [54.5–163.5], P = 0.0001); white blood cell count ([3.9–7.6] vs [5.5–13.6], P = 0.0002); D2 dimer ([172–836] vs [408–953], P = 0.005), PCT ([0.03–0.07] vs [0.04–0.15], P = 0.0039); CRP ([3.8–27.9] vs [17.3–58.9], P < 0.0001); AST ([16, 29] vs [18, 42], P = 0.0484); artificial liver therapy (2% vs 16.3%, P = 0.0148); and glucocorticoid therapy (64.7% vs 98%, P < 0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, Oxygen support, early treatment with low doses of glucocorticoids and artificial liver therapy, when necessary, may help reduce mortality in critically ill patients.

scholarly journals Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Blood Cell Count ◽  
Single Centre ◽  
Multiple Factors ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); BMI ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.

scholarly journals Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Blood Cell Count ◽  
Single Centre ◽  
Multiple Factors ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); BMI ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, Oxygen support, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.

scholarly journals Clinical characteristics and risk factors for severity of COVID-19 outside Wuhan: a double-center retrospective cohort study of 213 cases in Hunan, China

2020 ◽  
Vol 14 ◽  
pp. 175346662096303
Author(s):  
Xingsheng Hu ◽  
Chunhong Hu ◽  
Yong Yang ◽  
Juan Chen ◽  
Ping Zhong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Creatine Kinase ◽  
Cell Count ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
White Cell Count ◽  
Poor Appetite ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Aim: To investigate clinical characteristics and identify risk factors for severity of coronavirus disease 2019 (COVID-19) pneumonia outside of Wuhan, China. Materials and methods: We included 213 patients with confirmed COVID-19 who had been discharged or died by 15 March 2020. We retrospectively collected epidemiological, clinical, laboratory, computed tomography imaging and outcome data. Clinical characteristics were described and relative risk factors were compared. Results: Most clinical characteristics of this study were similar to those from studies in Wuhan, but there were lower mortality rate and milder severity. The median time from onset of symptoms to confirmation and hospitalization was 4 and 5 days, respectively. The median virus clearance and shedding times were 10 and 15 days, respectively. When the severe/critical group was compared with the mild/moderate group, significant risk factors included: older age; dyspnea; hypertension; poor appetite; fatigue; higher white cell count, neutrophil count, prothrombin time, creatine kinase, creatine kinase-MB, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein; and lower lymphocyte count and albumin ( p < 0.05). In the intensive care unit (ICU) group compared with the non-ICU group, risk factors included: older age; chronic obstructive pulmonary disease (COPD); dyspnea; poor appetite; higher white cell count, D-dimer, ALT, AST and LDH; and lower lymphocyte count and albumin ( p < 0.05). Independent risk factors associated with the severe/critical group were dyspnea [odds ratio (OR) = 19.48], ALT (OR = 6.02) and albumin (OR = 3.36). Independent risk factors associated with the ICU group were dyspnea (OR = 8.88), COPD (OR = 31.80), D-dimer (OR = 8.37), ALT (OR = 28.76) and LDH (OR = 9.95) ( p < 0.05). Conclusion: The severity of COVID-19 outside Wuhan, China was milder than that within Wuhan. The clinical infective period was long, and the longest virus shedding time was 35 days. The most important risk factors were dyspnea, COPD, D-dimer, ALT, LDH and albumin. The reviews of this paper are available via the supplemental material section.

The Clinical Characteristics of Obese Patients with Acanthosis Nigricans and Its Independent Risk Factors

2017 ◽  
Vol 125 (03) ◽  
pp. 191-195 ◽  
Author(s):  
Yueye Huang ◽  
Jiaqi Chen ◽  
Xingchun Wang ◽  
Yan Li ◽  
Shezhen Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Acanthosis Nigricans ◽  
Obese Patients ◽  
Independent Risk Factors

scholarly journals Risk Factors of Fatigue in Idiopathic Parkinson’s Disease in a Polish Population

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Monika Gołąb-Janowska ◽  
Dariusz Kotlęga ◽  
Krzysztof Safranow ◽  
Agnieszka Meller ◽  
Anna Budzianowska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Everyday Activity ◽  
Activity Intensity ◽  
Fatigue Syndrome ◽  
Moderate Depression ◽  
Fatigue Severity ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Introduction.Fatigue syndrome is one of the nonmotor symptoms in Parkinson’s disease (PD). The aim of the study was assessment of prevalence of fatigue syndrome in PD and answering the question what are the independent risk factors connected with intensity of fatigue in PD.Methods. 114 patients with idiopathic PD (mean age 62.2 + 10.8 years) were enrolled. The fatigue was assessed according to the Fatigue Severity Scale (FSS). We analyzed associations between fatigue and sex, age, education, duration and severity of the disease, everyday activity, intensity of the main symptoms, treatment, presence of dyskinesias and fluctuations, depression and excessive sleep during the day, and presence of pain and nycturia.Results. The fatigue syndrome was detected in 57.9% of patients. The score in the FSS was 1 to 7 points, 4.3 average. Greater fatigue intensity correlated with higher total daily levodopa equivalent dose. Patients with moderate depression had significantly greater fatigue.Conclusions. Fatigue syndrome affects 57.9% of patients with PD. Use of higher LED and presence of moderate depression are independent risk factors of greater intensity of fatigue.

scholarly journals Nomogram for Predicting COVID-19 Disease Progression Based on Single-Center Data: Observational Study and Model Development (Preprint)

2020 ◽  
Author(s):  
Tao Fan ◽  
Bo Hao ◽  
Shuo Yang ◽  
Bo Shen ◽  
Zhixin Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Disease Onset ◽  
Lasso Regression ◽  
Prediction Ability ◽  
Calibration Curves ◽  
Independent Risk Factors ◽  
Critical Patients

BACKGROUND In late December 2019, a pneumonia caused by SARS-CoV-2 was first reported in Wuhan and spread worldwide rapidly. Currently, no specific medicine is available to treat infection with COVID-19. OBJECTIVE The aims of this study were to summarize the epidemiological and clinical characteristics of 175 patients with SARS-CoV-2 infection who were hospitalized in Renmin Hospital of Wuhan University from January 1 to January 31, 2020, and to establish a tool to identify potential critical patients with COVID-19 and help clinical physicians prevent progression of this disease. METHODS In this retrospective study, clinical characteristics of 175 confirmed COVID-19 cases were collected and analyzed. Univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were used to select variables. Multivariate analysis was applied to identify independent risk factors in COVID-19 progression. We established a nomogram to evaluate the probability of progression of the condition of a patient with COVID-19 to severe within three weeks of disease onset. The nomogram was verified using calibration curves and receiver operating characteristic curves. RESULTS A total of 18 variables were considered to be risk factors after the univariate regression analysis of the laboratory parameters (<i>P</i>&lt;.05), and LASSO regression analysis screened out 10 risk factors for further study. The six independent risk factors revealed by multivariate Cox regression were age (OR 1.035, 95% CI 1.017-1.054; <i>P</i>&lt;.001), CK level (OR 1.002, 95% CI 1.0003-1.0039; <i>P</i>=.02), CD4 count (OR 0.995, 95% CI 0.992-0.998; <i>P</i>=.002), CD8 % (OR 1.007, 95% CI 1.004-1.012, <i>P</i>&lt;.001), CD8 count (OR 0.881, 95% CI 0.835-0.931; <i>P</i>&lt;.001), and C3 count (OR 6.93, 95% CI 1.945-24.691; <i>P</i>=.003). The areas under the curve of the prediction model for 0.5-week, 1-week, 2-week and 3-week nonsevere probability were 0.721, 0.742, 0.87, and 0.832, respectively. The calibration curves showed that the model had good prediction ability within three weeks of disease onset. CONCLUSIONS This study presents a predictive nomogram of critical patients with COVID-19 based on LASSO and Cox regression analysis. Clinical use of the nomogram may enable timely detection of potential critical patients with COVID-19 and instruct clinicians to administer early intervention to these patients to prevent the disease from worsening.

scholarly journals The Clinical Characteristics of Acute Myocardial Infarction with Ventricular Septal Perforation and the Prognosis Comparison of Different Treatment Methods

2020 ◽  
Author(s):  
Chun Fu ◽  
Zhou Zhao ◽  
Yu Chen ◽  
Youzhong An ◽  
Jian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Complete Revascularization ◽  
Septal Perforation ◽  
Survival Group ◽  
Term Survival ◽  
Related Risk ◽  
Incomplete Revascularization ◽  
Independent Risk Factors

Abstract Background: To explore the clinical characteristics of acute myocardial infarction (AMI) with ventricular septal perforation (VSR) and the prognosis comparison of different treatment methods, as well as the analysis of related risk factors.Methods: From January 2006 to February 2020, 29 patients with AMI and VSR diagnosed in the people's Hospital of Peking University were selected as the study object, among them, 16 cases were male (55.2%), 13 cases were female (44.8%), the average age was 64.69 ± 10.32 years old, and they were divided into survival group (n=16) and non-survival group (n=13) according to whether they survive within 30 days of surgical or drug conservative treatment.The clinical characteristics, coronary angiography and treatment of the two groups were summarized, and the prognosis and related risk factors were analyzed.Results: There was no significant difference in the basic clinical characteristics between the two groups(P>0.05)；Compared with the results of coronary angiography in the two groups, the proportion of the culprit vessel which was a simple anterior descending branch in the non-survival group was higher than that in the survival group, there was a statistical difference between the two groups(P<0.05)；The peri-operative data of the two groups showed that the proportion of patients with complete revascularization, simultaneous bypass and recanalization of culprit vessels in the survival group was significantly higher than that in the non- survival group (P < 0.05)；However, the incidence of postoperative low cardiac output and mortality during hospitalization in the survival group were significantly lower than those in the non-survival group (P < 0.05)；Logistic regression analysis showed that complete revascularization (OR = 0.021, 95% CI 0.001-0.374, P = 0.009), recanalization of culprit vessels (OR = 0.045, 95% CI 0.004-0.548, P = 0.015) were independent risk factors for 30 day mortality。Kaplan-Meier survival curve showed that during the follow-up period, the long-term survival rate of patients with operation and complete revascularization was significantly higher than that of patients with drug conservative treatment and incomplete revascularization, there was a statistical difference between the two groups (P < 0.05).Conclusions: Whether complete revascularization and recanalization of culprit vessels or not are independent risk factors for 30 day mortality in patients with AMI and VSR；the long-term survival rate of patients after surgery and complete revascularization is significantly higher than that of patients with conservative medical treatment and incomplete revascularization. Surgery and complete revascularization are important factors affecting the long-term prognosis of patients with AMI and VSR.

scholarly journals Clinical Characteristics and Risk Factors for Mortality in Very Old Patients Hospitalized With COVID-19 in Spain

2020 ◽  
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Verónica Buonaiuto ◽  
Michele Ricci ◽  
Jesica Martín-Carmona ◽  
Diana Paredes-Ruíz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Atherosclerotic Cardiovascular Disease ◽  
X Rays ◽  
Old Patients ◽  
Very Old ◽  
Independent Risk Factors ◽  
Male Sex

Abstract Background Advanced age is a well-known risk factor for poor prognosis in COVID-19. However, few studies have specifically focused on very old inpatients with COVID-19. This study aims to describe the clinical characteristics of very old inpatients with COVID-19 and identify risk factors for in-hospital mortality at admission. Methods We conducted a nationwide, multicenter, retrospective, observational study in patients ≥ 80 years hospitalized with COVID-19 in 150 Spanish hospitals (SEMI-COVID-19) Registry (March 1–May 29, 2020). The primary outcome was in-hospital mortality. A uni- and multivariate logistic regression was performed to assess predictors of mortality at admission. Results A total of 2772 consecutive patients (49.4% men, median age 86.3 years) were analyzed. Rates of atherosclerotic cardiovascular disease, diabetes mellitus, dementia, and Barthel Index &lt; 60 were 30.8%, 25.6%, 30.5%, and 21.0%, respectively. The overall case-fatality rate was 46.9% (n: 1301) and increased with age (80–84 years: 41.6%; 85–90 years: 47.3%; 90–94 years: 52.7%; ≥95 years: 54.2%). After analysis, male sex and moderate-to-severe dependence were independently associated with in-hospital mortality; comorbidities were not predictive. At admission, independent risk factors for death were: oxygen saturation &lt; 90%; temperature ≥ 37.8°C; quick sequential organ failure assessment (qSOFA) score ≥ 2; and unilateral–bilateral infiltrates on chest x-rays. Some analytical findings were independent risk factors for death, including estimated glomerular filtration rate &lt; 45 mL/min/1.73 m2; lactate dehydrogenase ≥ 500 U/L; C-reactive protein ≥ 80 mg/L; neutrophils ≥ 7.5 × 103/μL; lymphocytes &lt; 0.8 × 103/μL; and monocytes &lt; 0.5 × 103/μL. Conclusions This first large, multicenter cohort of very old inpatients with COVID-19 shows that age, male sex, and poor preadmission functional status—not comorbidities—are independently associated with in-hospital mortality. Severe COVID-19 at admission is related to poor prognosis.

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