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Published on: December 19, 2020
Clinical characteristics of Japanese patients with moderate to severe COVID-19
Ryota Otoshi1, Eri Hagiwara1, Takaaki Kitayama1
1Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
Insights
Older age and elevated C-reactive protein (CRP) are key indicators of severe COVID-19 in Japanese patients. These factors, along with comorbidities, help predict disease progression and inform early treatment strategies.
Area of Science:
- Infectious Diseases
- Epidemiology
- Internal Medicine
Background:
- Limited data exists on early indicators for severe COVID-19 in Japan.
- Understanding patient characteristics is crucial for predicting disease progression.
Purpose of the Study:
- To identify early indicators of severe COVID-19.
- To analyze patient characteristics associated with disease severity in a Japanese cohort.
Main Methods:
- Retrospective review of 300 hospitalized Japanese COVID-19 patients (February-November 2020).
- Comparison of clinical and laboratory data across mild, moderate, and severe disease groups.
- Multivariate analysis to identify independent risk factors for severe disease.
Main Results:
- Severe COVID-19 patients were older, had more comorbidities, and higher BMI.
- Lower lymphocyte counts and higher C-reactive protein (CRP), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) levels were associated with severity.
- Age (≥74 years) and CRP (≥3.15 mg/dL) were independent predictors of severe disease.
Conclusions:
- Age and CRP are independent risk factors for severe COVID-19.
- Underlying diseases, lymphocyte count, LDH, and D-dimer may also correlate with disease severity.
Introduction:
Although several reports on the risk factors for severe disease of COVID-19 already exist, reports on effective early indicators are still limited, especially from Japan. This study was conducted to clarify the patient's characteristics whose disease progressed to severe status.
Methods:
The medical records of all consecutive 300 Japanese patients hospitalized at our institution between February and November 2020 were retrospectively reviewed. The clinical characteristics were evaluated to compare between mild (no oxygen needed), moderate (oxygen needs of 1-4 L/min), and severe diseases (oxygen needs of 5 L/min or more).
Results:
The median age was 68 years old, with 123 (41.0%) males and 177 (59.0%) females. Of these, 199 patients (66.3%), 55 patients (18.3%), 46 patients (15.3%) patients were in the mild disease, moderate disease, severe disease groups, respectively. Patients with severe disease were more likely to be older, have more comorbidities, and tended to have higher body mass index. In laboratory data, lymphocyte count, levels of C-reactive protein (CRP), LDH, and AST on admission were significantly associated with the severity. In multivariate analysis, age and CRP were the independent risk factors for severe disease (OR = 1.050, 1.130, respectively). The optimal cut-off value for age was 74 years old and that for CRP was 3.15 mg/dL.
Conclusions:
Age and CRP were independently associated with disease severity of COVID-19 in multivariate analysis. Additionally, the numbers of underlying disease, lymphocyte count, and inflammatory markers such as LDH and D-dimer may also be related to disease severity.
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