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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 10 16; 10(1):17524.SR

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.

Authors+Show Affiliations

Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Medical Intensive Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Infective Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Infective Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Intensive Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. shuyangzhang103@nrdrs.org.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33067568

Citation

Tian, Ran, et al. "Clinical Characteristics and Survival Analysis in Critical and Non-critical Patients With COVID-19 in Wuhan, China: a Single-center Retrospective Case Control Study." Scientific Reports, vol. 10, no. 1, 2020, p. 17524.
Tian R, Wu W, Wang C, et al. 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;10(1):17524.
Tian, R., Wu, W., Wang, C., Pang, H., Zhang, Z., Xu, H., Luo, Q., Gao, P., Shi, J., Li, W., Qian, H., Guo, F., Li, T., Liu, Z., Wang, J., Zhou, X., Qin, Y., Yan, X., & Zhang, S. (2020). Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study. Scientific Reports, 10(1), 17524. https://doi.org/10.1038/s41598-020-74465-3
Tian R, et al. 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 10 16;10(1):17524. PubMed PMID: 33067568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study. AU - Tian,Ran, AU - Wu,Wei, AU - Wang,Chunyao, AU - Pang,Haiyu, AU - Zhang,Zhiyu, AU - Xu,Haopeng, AU - Luo,Qingfeng, AU - Gao,Peng, AU - Shi,Jihua, AU - Li,Wenbin, AU - Qian,Hao, AU - Guo,Fan, AU - Li,Taisheng, AU - Liu,Zhengyin, AU - Wang,Jinglan, AU - Zhou,Xiang, AU - Qin,Yan, AU - Yan,Xiaowei, AU - Zhang,Shuyang, Y1 - 2020/10/16/ PY - 2020/04/20/received PY - 2020/09/25/accepted PY - 2020/10/17/entrez PY - 2020/10/18/pubmed PY - 2020/10/29/medline SP - 17524 EP - 17524 JF - Scientific reports JO - Sci Rep VL - 10 IS - 1 N2 - 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. SN - 2045-2322 UR - https://www.unboundmedicine.com/medline/citation/33067568/Clinical_characteristics_and_survival_analysis_in_critical_and_non_critical_patients_with_COVID_19_in_Wuhan_China:_a_single_center_retrospective_case_control_study_ L2 - https://doi.org/10.1038/s41598-020-74465-3 DB - PRIME DP - Unbound Medicine ER -