Comparative Study of Acute Lung Injury in COVID-19 and Non-COVID-19 Patients

Background: Amid the coronavirus disease 2019 (COVID-19) pandemic, we analyzed clinical characteristics of acute lung injury (ALI) in COVID-19 patients and reported their similarity and dissimilarity to those of non-COVID-19 patients in the intensive care unit (ICU).Methods: We reported on 90 COVID-19 and 130 non-COVID-19 ALI patients in the ICUs of multiple centers. Demographic data, medical histories, laboratory findings, and radiological images were analyzed and compared between the two cohorts and within each cohort between survivors and non-survivors. For ALI survivors, clinical characteristics before and after treatment were also compared.Findings: Aberrations in blood parameters, such as leukocytosis, neutrophilia, and thrombocytopenia, were observed in both cohorts. More characteristic abnormalities, including significantly higher red cell distribution width (RDW), C-reactive proteins, and lactic dehydrogenase (LDH) but lower troponin (TnT) and procalcitonin, were observed in the COVID-19 cohort than in the non-COVID-19 cohort, whereas D-dimer levels showed a similar elevation in both cohorts. The COVID-19 cohort also showed more diversified CT patterns where severe features such as consolidations and crazy paving patterns were more frequently observed. Multivariate analysis indicated that age, fever symptom, prothrombin time, procalcitonin, partial pressure of carbon dioxide, oxygenated hemoglobin, and crazy paving patterns in CT scans were independent risk factors associated with COVID-19.Interpretation: Comparison of ALI characteristics between COVID-19 and non-COVID-19 patients in the ICU setting provided insight into the pathogenesis of ALI induced by different risk factors, suggesting distinct treatment plans.

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Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19): A Retrospective Cohort Study

10.21203/rs.3.rs-36077/v3 ◽

2020 ◽

Author(s):

Zhihua Yu ◽

Yuhe Ke ◽

Jiang Xie ◽

Hao Yu ◽

Wei Zhu ◽

...

Keyword(s):

Risk Factors ◽

Body Temperature ◽

Clinical Characteristics ◽

Troponin I ◽

Fatal Outcome ◽

High Sensitivity ◽

Lactic Dehydrogenase ◽

Hospital Death ◽

Laboratory Findings ◽

Novel Coronavirus

Abstract Background：Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death.Methods：A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31st March 2020.Results：The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO2≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions：In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.

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Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19) :A Retrospective Cohort Study

10.21203/rs.3.rs-36077/v1 ◽

2020 ◽

Author(s):

Zhihua Yu ◽

Yuhe Ke ◽

Jiang Xie ◽

Hao Yu ◽

Wei Zhu ◽

...

Keyword(s):

Risk Factors ◽

Body Temperature ◽

Clinical Characteristics ◽

Troponin I ◽

Fatal Outcome ◽

High Sensitivity ◽

Lactic Dehydrogenase ◽

Hospital Death ◽

Laboratory Findings ◽

Novel Coronavirus

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Clinical characteristics on admission predict in-hospital fatal outcome in patients aged ≥75 years with novel coronavirus disease (COVID-19): a retrospective cohort study

BMC Geriatrics ◽

10.1186/s12877-020-01921-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zhihua Yu ◽

Yuhe Ke ◽

Jiang Xie ◽

Hao Yu ◽

Wei Zhu ◽

...

Keyword(s):

Risk Factors ◽

Body Temperature ◽

Clinical Characteristics ◽

Troponin I ◽

Fatal Outcome ◽

High Sensitivity ◽

Lactic Dehydrogenase ◽

Hospital Death ◽

Laboratory Findings ◽

Novel Coronavirus

Abstract Background Novel coronavirus disease 2019 (COVID-19) has become a worldwide pandemic and precise fatality data by age group is needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was on the 31st March 2020. Results The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation (SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P < 0.05) than patients who recovered. Male sex (odds ratio [OR] = 13.1, 95% confidence interval [CI] 1.1 to 160.1, P = 0.044), body temperature > 37.3 °C (OR = 80.5, 95% CI 4.6 to 1407.6, P = 0.003), SpO2 ≤ 90% (OR = 70.1, 95% CI 4.6 to 1060.4, P = 0.002), and NT-proBNP> 1800 ng/L (OR = 273.5, 95% CI 14.7 to 5104.8, P < 0.0001) were independent risk factors of in-hospital death. Conclusions In-hospital fatality among elderly COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.

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Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19) :A Retrospective Cohort Study

10.21203/rs.3.rs-36077/v2 ◽

2020 ◽

Author(s):

Zhihua Yu ◽

Yuhe Ke ◽

Jiang Xie ◽

Hao Yu ◽

Wei Zhu ◽

...

Keyword(s):

Risk Factors ◽

Body Temperature ◽

Clinical Characteristics ◽

Troponin I ◽

Fatal Outcome ◽

High Sensitivity ◽

Lactic Dehydrogenase ◽

Hospital Death ◽

Laboratory Findings ◽

Novel Coronavirus

Abstract Background ： Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods ： A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12 th and 19 th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31 st March 2020. Results ： The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO 2 ) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO 2 ≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions： In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO 2 , and NT-proBNP. Key words ： Coronavirus disease; SARS-CoV-2; elderly; death; prediction

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Analysis of Risk Factors Associated with Outcomes in Road Traffic Injury Patients with Acute Lung Injury

Journal of International Medical Research ◽

10.1177/147323000903700327 ◽

2009 ◽

Vol 37 (3) ◽

pp. 835-840

Author(s):

L Sheng ◽

J-S Wu ◽

M Zhang ◽

S-W Xu ◽

J-X Gan ◽

...

Keyword(s):

Risk Factors ◽

Acute Lung Injury ◽

Lung Injury ◽

Road Traffic ◽

Road Traffic Injury ◽

Apache Ii Score ◽

Factors Associated ◽

Traffic Injury ◽

Short And Long Term

Over 50% of road traffic injury (RTI) patients experience post-traumatic acute lung injury (ALI) and it is, therefore, extremely important to identify the risk factors related to the poor outcomes associated with ALI in RTI populations. This study evaluated 19 potential risk factors associated with the outcomes of ALI in 366 RTI patients. They were divided into two groups: a ‘favourable outcomes group’ and an ‘unfavourable outcomes group’. The results indicated that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the presence of gastrointestinal haemorrhage may help predict the outcomes of ALI in the early post-trauma phase of treatment. The duration of trauma and sepsis were shown to impact strongly on both the short- and long-term outcomes of ALI. Age (≥ 65 years) and disseminated intravascular coagulation in the early RTI phase were also independent risk factors for a poorer short- and long-term outcome in ALI.

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Clinical Characteristics, Risk Factors and Predictive Value of COVID-19 Pneumonia: A Retrospective Study of 173 Patients in Wuhan, China

10.21203/rs.3.rs-76134/v1 ◽

2020 ◽

Author(s):

Yang Zhang ◽

Jun Xue ◽

Mi Yan ◽

Jing Chen ◽

Hai Liu ◽

...

Keyword(s):

Risk Factors ◽

Predictive Model ◽

Disease Severity ◽

Roc Curve ◽

Predictive Value ◽

Older Patients ◽

Clinical Characteristics ◽

Lactic Dehydrogenase ◽

Older Age ◽

Hospital Outcome

Abstract Background: COVID-19 is a globally emerging infectious disease. As the global epidemic continues to spread, the risk of COVID-19 transmission and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia from Wuhan. Methods: Patients with COVID-19 pneumonia admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models.Results: 106 (61.3%) of the patients were female. The mean age of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension (24.9%). The most common symptoms on admission were fever (67.6%) and cough (60.1%), digestive symptoms (22.0%) was also very common. Older age (OR: 3.420; 95%Cl: 1.415-8.266; P=0.006), diarrhea (OR: 0.143; 95%Cl: 0.033-0.611; P=0.009) and lymphopenia (OR: 4.769; 95%Cl: 2.019-11.266; P=0.000) were associated with severe illness on admission; the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918; P=0.000). Older age (OR: 0.309; 95%Cl: 0.142-0.674; P=0.003), leucopenia (OR: 0.165; 95%Cl: 0.034-0.793; P=0.025), increased lactic dehydrogenase (OR: 0.257; 95%Cl: 0.100-0.659; P=0.005) and interleukins-6 levels (OR: 0.294; 95%Cl: 0.099-0.872; P=0.027) were associated with poor in-hospital outcome; AUC of predictive model were 0.752 (95%CI: 0.681-0.824; P=0.000).Conclusion: Older patients with diarrhea and lymphopenia need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome.Trial registration: ChiCTR2000029549

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Risk Factors for Transfusion-Related Acute Lung Injury in Critical Patients Admitted in Intensive Care Unit: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-52231/v1 ◽

2020 ◽

Author(s):

Lunyang Hu ◽

Baoli Wang ◽

Yong Jiang ◽

Banghui Zhu ◽

Chen Wang ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Acute Lung Injury ◽

Blood Transfusion ◽

Lung Injury ◽

Chronic Alcohol ◽

Related Factors ◽

Chronic Alcohol Abuse ◽

Related Risk ◽

Critical Patients

Abstract Background: Until now, transfusion-related acute lung injury (TRALI) has been considered to be the leading cause of blood transfusion-related diseases and death. And there is no clinically effective treatment plan for TRALI. The aim of this study was to systematically summarize the literature on risk factors for TRALI in critical patients. Methods: Electronic searches (up to March 2020) were performed in the Cochrane Library, Web of Knowledge, Embase, and PubMed databases. We included studies reporting on the risk factors of TRALI for critical patients and extracted the risk factors. Finally, third studies met the inclusion criteria. Results: We summarized and analyzed the potential risk factors of TRALI for critical patients in 13 existing studies. The host-related factors were age (odds ratio (OR) [95% confidence interval] = 1.16 [1.08-1.24]), sex (OR = 1.26 [1.16-1.38]), tobacco use status (OR = 3.82 [1.91-7.65]), chronic alcohol abuse (OR = 3.82 [2.97-26.83]), fluid balance (OR = 1.24 [1.08-1.42]), shock before transfusion (OR = 4.41 [2.38-8.20]), and ASA score of the recipients (OR = 2.72 [1.43-5.16]). The transfusion-related factors were the number of transfusions (OR = 1.40 [1.14-1.72]) and fresh frozen plasma (FFP) units (OR = 1.21 [1.01-1.46]). The device-related factor was mechanical ventilation (OR = 4.13 [2.20-7.76]). Conclusions: The risk factors for TRALI in this study included age, sex, tobacco use, chronic alcohol abuse, fluid balance, shock before transfusion, ASA score, number of transfusions, FFP units and mechanical ventilation. Our study suggests that host-related risk factors play a more important role in the occurrence and development of TRALI than blood transfusion-related risk factors.

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