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Risk factors for developing into critical COVID-19 patients in Wuhan, China: A multicenter, retrospective, cohort

Dan Liu1, Pengfei Cui1, Shaoqing Zeng1

  • 1National Medical Center for Major Public Health Events, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China.

Eclinicalmedicine
|August 26, 2020
PubMed

Insights

COVID-19 critical illness risk factors differ by sex. Age, hypertension, and coronary heart disease are key for males, while COPD, CKD, and age are critical for females.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Clinical Medicine

Background:

  • COVID-19 poses a significant global health threat, with critically ill patients experiencing substantially higher mortality rates.
  • Understanding clinical features and risk factors for severe COVID-19 is crucial for effective patient management.
  • Previous studies have highlighted varying outcomes, necessitating further investigation into disease progression and contributing factors.

Purpose of the Study:

  • To comprehensively delineate the clinical features of COVID-19 across different severity levels.
  • To identify and analyze risk factors associated with the development of critical COVID-19.
  • To explore potential sex-based differences in these risk factors.

Main Methods:

  • A retrospective cohort study involving 2,387 COVID-19 inpatients.
  • Data collected from electronic medical records between January 27 and March 21, 2020.
  • Statistical analysis, including logistic and multivariable regression, to identify risk factors for critical illness.

Main Results:

  • COVID-19 severity increases with age. Critical cases showed higher rates of dyspnea, organ damage, and prolonged inflammation.
  • All-cause mortality was significantly higher in the critical group (85.45%) compared to severe (0.58%) and moderate (0.18%) groups.
  • Sex modifies risk: hypertension and coronary heart disease (CHD) are risk factors for males, while chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), tumor, and age (≥60) are risk factors for females.

Conclusions:

  • This study provides crucial insights into COVID-19 clinical characteristics and sex-specific risk factors for critical illness.
  • Identifying distinct risk factors between sexes is vital for targeted clinical and epidemiological strategies in COVID-19 management.
  • These findings may also inform approaches to future coronavirus outbreaks.
Abstract

Keywords:
Covid-19Risk factorsSeverity of diseaseSex

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