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Clinical characteristics and risk factors for severity of COVID-19 outside Wuhan: a double-center retrospective cohort study of 213 cases in Hunan, China.
Ther Adv Respir Dis. 2020 Jan-Dec; 14:1753466620963035.TA

Abstract

AIM

To investigate clinical characteristics and identify risk factors for severity of coronavirus disease 2019 (COVID-19) pneumonia outside of Wuhan, China.

MATERIALS AND METHODS

We included 213 patients with confirmed COVID-19 who had been discharged or died by 15 March 2020. We retrospectively collected epidemiological, clinical, laboratory, computed tomography imaging and outcome data. Clinical characteristics were described and relative risk factors were compared.

RESULTS

Most clinical characteristics of this study were similar to those from studies in Wuhan, but there were lower mortality rate and milder severity. The median time from onset of symptoms to confirmation and hospitalization was 4 and 5 days, respectively. The median virus clearance and shedding times were 10 and 15 days, respectively. When the severe/critical group was compared with the mild/moderate group, significant risk factors included: older age; dyspnea; hypertension; poor appetite; fatigue; higher white cell count, neutrophil count, prothrombin time, creatine kinase, creatine kinase-MB, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein; and lower lymphocyte count and albumin (p < 0.05). In the intensive care unit (ICU) group compared with the non-ICU group, risk factors included: older age; chronic obstructive pulmonary disease (COPD); dyspnea; poor appetite; higher white cell count, D-dimer, ALT, AST and LDH; and lower lymphocyte count and albumin (p < 0.05). Independent risk factors associated with the severe/critical group were dyspnea [odds ratio (OR) = 19.48], ALT (OR = 6.02) and albumin (OR = 3.36). Independent risk factors associated with the ICU group were dyspnea (OR = 8.88), COPD (OR = 31.80), D-dimer (OR = 8.37), ALT (OR = 28.76) and LDH (OR = 9.95) (p < 0.05).

CONCLUSION

The severity of COVID-19 outside Wuhan, China was milder than that within Wuhan. The clinical infective period was long, and the longest virus shedding time was 35 days. The most important risk factors were dyspnea, COPD, D-dimer, ALT, LDH and albumin.The reviews of this paper are available via the supplemental material section.

Authors+Show Affiliations

Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China.Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China.Department of Intensive care unit, Changsha Central Hospital of Nanhua University, Changsha, Hunan, P.R. China.Department of Radiology, The Central Hospital of Xiangtan, Hunan, Xiangtan, Hunan, P.R. China.Department of Dermatology, Nanchong Central Hospital, Nanchong, Sichuan, P.R. China.Department of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, P.R. China.Department of Radiology, The Second Xiangya Hospital of Central South University, No.139 People Road of Changsha City, 410011 Changsha, Hunan, P.R. China. Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China.

Pub Type(s)

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

Language

eng

PubMed ID

33138694

Citation

Hu, Xingsheng, et al. "Clinical Characteristics and Risk Factors for Severity of COVID-19 Outside Wuhan: a Double-center Retrospective Cohort Study of 213 Cases in Hunan, China." Therapeutic Advances in Respiratory Disease, vol. 14, 2020, p. 1753466620963035.
Hu X, Hu C, Yang Y, et al. Clinical characteristics and risk factors for severity of COVID-19 outside Wuhan: a double-center retrospective cohort study of 213 cases in Hunan, China. Ther Adv Respir Dis. 2020;14:1753466620963035.
Hu, X., Hu, C., Yang, Y., Chen, J., Zhong, P., Wen, Y., & Chen, X. (2020). Clinical characteristics and risk factors for severity of COVID-19 outside Wuhan: a double-center retrospective cohort study of 213 cases in Hunan, China. Therapeutic Advances in Respiratory Disease, 14, 1753466620963035. https://doi.org/10.1177/1753466620963035
Hu X, et al. Clinical Characteristics and Risk Factors for Severity of COVID-19 Outside Wuhan: a Double-center Retrospective Cohort Study of 213 Cases in Hunan, China. Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620963035. PubMed PMID: 33138694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and risk factors for severity of COVID-19 outside Wuhan: a double-center retrospective cohort study of 213 cases in Hunan, China. AU - Hu,Xingsheng, AU - Hu,Chunhong, AU - Yang,Yong, AU - Chen,Juan, AU - Zhong,Ping, AU - Wen,Yajing, AU - Chen,Xiangyu, PY - 2020/11/3/entrez PY - 2020/11/4/pubmed PY - 2020/11/20/medline KW - coronavirus disease 2019 (COVID-19) KW - critical KW - intensive care unit (ICU) KW - risk factors KW - severe SP - 1753466620963035 EP - 1753466620963035 JF - Therapeutic advances in respiratory disease JO - Ther Adv Respir Dis VL - 14 N2 - AIM: To investigate clinical characteristics and identify risk factors for severity of coronavirus disease 2019 (COVID-19) pneumonia outside of Wuhan, China. MATERIALS AND METHODS: We included 213 patients with confirmed COVID-19 who had been discharged or died by 15 March 2020. We retrospectively collected epidemiological, clinical, laboratory, computed tomography imaging and outcome data. Clinical characteristics were described and relative risk factors were compared. RESULTS: Most clinical characteristics of this study were similar to those from studies in Wuhan, but there were lower mortality rate and milder severity. The median time from onset of symptoms to confirmation and hospitalization was 4 and 5 days, respectively. The median virus clearance and shedding times were 10 and 15 days, respectively. When the severe/critical group was compared with the mild/moderate group, significant risk factors included: older age; dyspnea; hypertension; poor appetite; fatigue; higher white cell count, neutrophil count, prothrombin time, creatine kinase, creatine kinase-MB, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein; and lower lymphocyte count and albumin (p < 0.05). In the intensive care unit (ICU) group compared with the non-ICU group, risk factors included: older age; chronic obstructive pulmonary disease (COPD); dyspnea; poor appetite; higher white cell count, D-dimer, ALT, AST and LDH; and lower lymphocyte count and albumin (p < 0.05). Independent risk factors associated with the severe/critical group were dyspnea [odds ratio (OR) = 19.48], ALT (OR = 6.02) and albumin (OR = 3.36). Independent risk factors associated with the ICU group were dyspnea (OR = 8.88), COPD (OR = 31.80), D-dimer (OR = 8.37), ALT (OR = 28.76) and LDH (OR = 9.95) (p < 0.05). CONCLUSION: The severity of COVID-19 outside Wuhan, China was milder than that within Wuhan. The clinical infective period was long, and the longest virus shedding time was 35 days. The most important risk factors were dyspnea, COPD, D-dimer, ALT, LDH and albumin.The reviews of this paper are available via the supplemental material section. SN - 1753-4666 UR - https://www.unboundmedicine.com/medline/citation/33138694/Clinical_characteristics_and_risk_factors_for_severity_of_COVID_19_outside_Wuhan:_a_double_center_retrospective_cohort_study_of_213_cases_in_Hunan_China_ DB - PRIME DP - Unbound Medicine ER -