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Clinical characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, China

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单位: [1]Wuhan Univ, Dept Resp & Crit Care Med, Renmin Hosp, Wuhan, Hubei, Peoples R China [2]Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Key Lab Environm & Hlth,Dept Epidemiol & Biostat, 13 Hangkong Rd, Wuhan 430030, Hubei, Peoples R China [3]Huazhong Univ Sci & Technol, Minist Educ, Key Lab Environm & Hlth, Wuhan, Hubei, Peoples R China [4]Huazhong Univ Sci & Technol, Minist Environm Protect, Wuhan, Hubei, Peoples R China [5]Huazhong Univ Sci & Technol, State Key Lab Environm Hlth Incubating, Sch Publ Hlth, Tongji Med Coll, Wuhan, Hubei, Peoples R China [6]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Urol,1095 Jiefang Ave,Wuhan 430030,Hubei,Peoples R China [7]Huazhong Univ Sci & Technol, Tongji Med Coll, Inst Reprod Hlth, Wuhan, Hubei, Peoples R China [8]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Crit Care Med,Wuhan,Hubei,Peoples R China [9]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Oncol,Wuhan,Hubei,Peoples R China [10]Chinese Acad Med Sci, Beijing Hosp, Natl Ctr Gerontol, Inst Geriatr Med,Dept Gen Surg, Beijing, Peoples R China [11]Nanjing Med Univ, Dept Cardiothorac Surg, Nanjing Childrens Hosp, Nanjing, Jiangsu, Peoples R China [12]Qinghai Univ, Dept Gen Surg, Affiliated Hosp, Xining, Qinghai, Peoples R China [13]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Comp Ctr,Wuhan,Hubei,Peoples R China [14]Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Immunol, Wuhan, Hubei, Peoples R China [15]Wuhan Ctr Dis Prevent & Control, Dept Virol, Wuhan, Hubei, Peoples R China [16]Wuhan Univ, Sch Hlth Sci, Wuhan 430071, Peoples R China
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关键词: COVID-19 Death risk Risk prediction models Immune cells subsets

摘要:
Background The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted. Methods In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020. Results Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19. Conclusions The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 4 区 传染病学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 传染病学
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出版当年[2019]版:
Q3 INFECTIOUS DISEASES
最新[2023]版:
Q2 INFECTIOUS DISEASES

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第一作者单位: [1]Wuhan Univ, Dept Resp & Crit Care Med, Renmin Hosp, Wuhan, Hubei, Peoples R China
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