Association Between Clinical Manifestations and Prognosis in Patients with COVID-19

Clin Ther. 2020 Jun;42(6):964-972. doi: 10.1016/j.clinthera.2020.04.009. Epub 2020 Apr 27.

Abstract

Purpose: The purpose of this study was to determine the risk factors associated with pneumonia, acute respiratory distress syndrome (ARDS), and clinical outcome among patients with novel coronavirus disease 2019 (COVID-19).

Methods: This was a cross-sectional multicenter clinical study. A total of 95 patients infected with COVID-19 were enrolled. The COVID-19 diagnostic standard was polymerase chain reaction detection of target genes of 2019 novel coronavirus (2019-nCoV). Clinical, laboratory, and radiologic results, as well as treatment outcome data, were obtained. ARDS was defined as an oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) ≤300 mm Hg.

Findings: Multivariate analysis showed that older age (odds ratio [OR], 1.078; p = 0.008) and high body mass index (OR, 1.327; p = 0.024) were independent risk factors associated with patients with pneumonia. For patients with ARDS, multivariate analysis showed that only high systolic blood pressure (OR, 1.046; p = 0.025) and high lactate dehydrogenase level (OR, 1.010; p = 0.021) were independent risk factors associated with ARDS. A total of 70 patients underwent CT imaging repeatedly after treatment. Patients were divided in a disease exacerbation group (n = 19) and a disease relief group (n = 51). High body mass index (OR, 1.285; p = 0.017) and tobacco smoking (OR, 16.13; p = 0.032) were independent risk factors associated with disease exacerbation after treatment.

Implications: These study results help in the risk stratification of patients with 2019-nCoV infection. Patients with risk factors should be given timely intervention to avoid disease progression.

Keywords: 2019-nCoV; Acute respiratory distress syndrome; COVID-19; Pneumonia; Risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Coronavirus Infections / blood*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / physiopathology
  • Cross-Sectional Studies
  • Humans
  • Hypertension / blood*
  • Hypertension / mortality
  • Hypertension / physiopathology
  • L-Lactate Dehydrogenase / blood*
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / physiopathology
  • Prognosis
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • L-Lactate Dehydrogenase