Risk Factors on the Progression to Clinical Outcomes of COVID-19 Patients in South Korea: Using National Data

Int J Environ Res Public Health. 2020 Nov 28;17(23):8847. doi: 10.3390/ijerph17238847.

Abstract

10-20% of COVID (Corona Virus Disease)-19 cases proceed to a severe stage, and age and the presence of comorbidity increased the risk of death from COVID-19. The identification of risk factors on progression to the severity stages is essential in providing more efficient and suitable management to COVID-19 patients. However, there is insufficient study on risk factors for severity stages of COVID-19 patients. In this study, 2959 confirmed COVID-19 patients were analyzed while using national data, COVID-19 patients Clinical Epidemiological Information provided from the Korea Disease Control and Prevention Agency. The epidemiological variable, hospital room, periods from confirmation to release, initial symptom and vital signs, underlying comorbidities, and initial blood variables were used to verify the relation with progression to severity stages of COVID-19 and severe COVID-19. The chi-square test, welch test, multiple regression and logistic regression analysis were performed. The ICU (Intensive Care Unit) admission rate of patients having characteristics, such as older age, male, abnormal BMI (Body Mass Index), high heart rate, high body temperature, fever, cough, sputum, sore throat, rhinorrhea, fatigue, dyspnea, change of consciousness, diabetes mellitus, hypertension, chronic artery disease, chronic kidney disease, cancer, dementia, abnormal hemoglobin, abnormal hematocrit, abnormal lymphocyte, abnormal platelets, and abnormal white blood cell were high. The risk factors for severe COVID-19 were older age, shorter hospitalization, abnormal lymphocyte, abnormal platelets, dyspnea, change of consciousness, and dementia. Whereas, significant predictors for progression to severity stages of COVID-19 were older age, longer period from confirmation to release, higher BMI, higher body temperature, abnormal lymphocyte, abnormal platelets, fever, no sore throat, dyspnea, no headache, COPD (Chronic Obstructive Pulmonary Disease), and dementia. Therefore, classifying patients with a high risk of severe stage of COVID-19 and managing patients by considering the risk factors could be helpful in the efficient management of COVID-19 patients.

Keywords: COVID-19; ICU; blood variables; risk factor; severity.

MeSH terms

  • Age Factors
  • COVID-19 / diagnosis*
  • Comorbidity
  • Disease Progression*
  • Hospitalization
  • Humans
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors