Related Experiment Video
Updated: Dec 24, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan
Xiaochen Li1, Shuyun Xu1, Muqing Yu1
1Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China.
Insights
Severe COVID-19 patients, particularly older males with comorbidities like hypertension and heart injury, face higher mortality risks. Early intervention is crucial for those with risk factors such as high lactate dehydrogenase levels.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- The initial COVID-19 outbreak in Wuhan highlighted limited data on severe cases.
- Understanding clinical characteristics and outcomes of severe COVID-19 is critical.
Purpose of the Study:
- To evaluate severity on admission, complications, treatment, and outcomes in COVID-19 patients.
- To identify risk factors associated with severe COVID-19 and mortality.
Main Methods:
- Retrospective analysis of 548 COVID-19 patients admitted to Tongji Hospital.
- Multivariable logistic regression and Cox proportional hazard models were used for risk and survival analyses.
Main Results:
- 49.1% of patients were classified as severe on admission.
- Older age, hypertension, elevated cytokines (IL-2R, IL-6, IL-10, TNF-α), and high lactate dehydrogenase predicted severity.
- Mortality was 32.5% in severe cases versus 1.1% in non-severe cases.
- Male sex, older age, leukocytosis, high lactate dehydrogenase, cardiac injury, hyperglycemia, and high-dose corticosteroid use predicted death in severe patients.
Conclusions:
- Older age, hypertension, and high lactate dehydrogenase levels necessitate close monitoring and early intervention for severe COVID-19.
- Severe male patients with cardiac injury, hyperglycemia, and high-dose corticosteroid use are at high risk of mortality.
Background:
In December 2019, the coronavirus disease 2019 (COVID-19) outbreak occurred in Wuhan. Data on the clinical characteristics and outcomes of patients with severe COVID-19 are limited.
Objective:
We sought to evaluate the severity on admission, complications, treatment, and outcomes of patients with COVID-19.
Methods:
Patients with COVID-19 admitted to Tongji Hospital from January 26, 2020, to February 5, 2020, were retrospectively enrolled and followed-up until March 3, 2020. Potential risk factors for severe COVID-19 were analyzed by a multivariable binary logistic model. Cox proportional hazard regression model was used for survival analysis in severe patients.
Results:
We identified 269 (49.1%) of 548 patients as severe cases on admission. Older age, underlying hypertension, high cytokine levels (IL-2R, IL-6, IL-10, and TNF-α), and high lactate dehydrogenase level were significantly associated with severe COVID-19 on admission. The prevalence of asthma in patients with COVID-19 was 0.9%, markedly lower than that in the adult population of Wuhan. The estimated mortality was 1.1% in nonsevere patients and 32.5% in severe cases during the average 32 days of follow-up period. Survival analysis revealed that male sex, older age, leukocytosis, high lactate dehydrogenase level, cardiac injury, hyperglycemia, and high-dose corticosteroid use were associated with death in patients with severe COVID-19.
Conclusions:
Patients with older age, hypertension, and high lactate dehydrogenase level need careful observation and early intervention to prevent the potential development of severe COVID-19. Severe male patients with heart injury, hyperglycemia, and high-dose corticosteroid use may have a high risk of death.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:23Acute Respiratory Failure-IV