Luo Yuchuan*, 1, Xiong Mengqing*, 2, Liu Hailing1, Zhao Dong2, Hu Ke1
1Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road No. 99, Wuhan 430060, China - 2The first clinical college of Medical College of Wuhan University, Zhangzhidong Road No. 99, Wuhan 430060, China
Background and Purpose: Corona Virus Disease 2019 (COVID-19) is a highly contagious disease which continuously and rapidly circulating around the world now. The patients with severe COVID-19 have relatively high mortality. Therefore, there is an urgent need for methods to assess mortality risk in patients with COVID-19 accurately.
Materials and methods: We conducted a retrospective study focusing on the clinical characteristics of 194 confirmed cases of severe COVID-19. Personal information, clinical data and laboratory information of patients with COVID-19 were collected by consulting case records so as to investigate the risk of death related to COVID-19.
Results: In the 194 patients with COVID-19, there was no difference in prevalence between men and women. Comorbidities (such as hypertension, cerebral infarction) associated with severe clinical features and mortality are prevalent in non-survivors. 86.1% of patients with severe COVID-19 had fever and 46.9% coughed, and the proportion of chest tightness, airlessness and dyspnea in non-survivors was significantly higher than that in survivors. There were multiple laboratory indicator differences between survivors and non-survivors. Non-survivors had significantly lower lymphocyte count (including T lymphocyte). Changes in liver (aspartate aminotransferase, AST), kidney [Urea, creatinine (Cr)], and heart [lactate dehydrogenase (LDH), creatine kinase (CK), B-type natriuretic peptide (BNP)] damage markers, coagulation, and inflammation indicators in severe patients were related to their risk of death. Multivariable logistic regression model revealed that age (OR 1.082, 95% CI 1.024-1.357), interleukin-6 (IL-6). (OR 1.568, 95% CI 1.149-2.138), D-dimer (OR 1.327, 95% CI 1.087-1.621) were associated significantly with risk of death, whereas CD4 count was associated with a lower risk (OR 0.972, 95% CI 0.953-0.992).
Conclusion: This study found that age, IL-6, D-dimer and CD4 counts are closely related to mortality risk in patients with severe COVID-19, and they are useful in assessing the prognosis of patients.
COVID-19, patient; severe, clinical characteristics, mortality risk.