Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study

Sci Rep. 2020 Oct 16;10(1):17524. doi: 10.1038/s41598-020-74465-3.

Abstract

Since the outbreak of COVID-19 in China at the end of 2019, the world has experienced a large-scale epidemic caused by the SARS-CoV-2. The epidemiological and clinical course of COVID-19 patients has been reported, but there have been few analyses about the characteristics, predictive risk factors, and outcomes of critical patients. In this single-center retrospective case-control study, 90 adult inpatients hospitalized at Tongji Hospital (Wuhan, China) were included. Demographic, clinical, laboratory tests, and treatment data were obtained and compared between critical and non-critical patients. We found that compared with non-critical patients, the critical patients had higher SOFA score and qSOFA scores. Critical patients had lower lymphocyte and platelet count, elevated D-dimer, decreased fibrinogen, and elevated high-sensitivity C-reactive protein (hsCRP), and interleukin-6(IL-6). More critical patients received treatment including antibiotics, anticoagulation, corticosteroid, and oxygen therapy than non-critical ones. Multivariable regression showed higher qSOFA score and elevation of IL-6 were related to critical patients. Antibiotic usage and anticoagulation were associated with decreased in-hospital mortality. And critical grouping contributed greatly to in-hospital death. Critical COVID-19 patients have a more severe clinical course. qSOFA score and elevation of IL-6 are risk factors for critical condition. Non-critical grouping, positive antibiotic application, and anticoagulation may be beneficial for patient survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Case-Control Studies
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / mortality
  • Coronavirus Infections / pathology*
  • Coronavirus Infections / virology
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Hospital Mortality
  • Humans
  • Interleukin-6 / metabolism
  • Kaplan-Meier Estimate
  • Logistic Models
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Odds Ratio
  • Organ Dysfunction Scores
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / pathology*
  • Pneumonia, Viral / virology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Fibrin Fibrinogen Degradation Products
  • Interleukin-6
  • fibrin fragment D