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Clinical Characteristics and Prognostic Factors of Severe COVID-19

Yun Yang1, Ziyi Huang1, Yongjian Pei1

  • 1Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, People's Republic of China.

Infection and Drug Resistance
|June 30, 2025
PubMed

Insights

Severe COVID-19 patients with high white blood cell (WBC) count, platelet (PLT) count, APACHE II score, and mechanical ventilation (MV) have a higher mortality risk. These factors combined offer strong predictive value for COVID-19 patient outcomes.

Area of Science:

  • Clinical Medicine
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease-2019 (COVID-19) presents a significant global health challenge with high mortality rates.
  • Severe COVID-19 cases impose a substantial economic burden worldwide.
  • Early identification of severe cases is crucial for improving patient prognosis and reducing mortality.

Purpose of the Study:

  • To investigate the clinical characteristics of patients with severe COVID-19.
  • To identify prognostic factors associated with mortality in severe COVID-19.
  • To develop a predictive model for early identification of high-risk severe COVID-19 cases.

Main Methods:

  • Retrospective analysis of clinical data from 98 severe COVID-19 patients.
  • Classification of patients into survivors and non-survivors based on hospitalization outcomes.
  • Univariate and multivariate logistic regression analyses to identify risk factors.
  • Receiver operating characteristic (ROC) curve analysis to evaluate predictive values.

Main Results:

  • Non-survivors exhibited higher white blood cell (WBC) count, platelet (PLT) count, APACHE II score, and neutrophil count compared to survivors.
  • Non-survivors had increased incidence of acute kidney injury (AKI), mechanical ventilation (MV), and continuous renal replacement therapy (CRRT).
  • Independent risk factors for poor prognosis included elevated WBC count (AUC=0.807), PLT count (AUC=0.690), APACHE II score (AUC=0.761), and MV (AUC=0.751).
  • Combined risk factors demonstrated a high predictive value with an AUC of 0.897.

Conclusions:

  • Elevated WBC count, PLT count, APACHE II score, and the need for MV are independent predictors of mortality in severe COVID-19.
  • These clinical indicators, particularly when assessed collectively, provide robust predictive value for identifying patients at high risk of mortality.
  • Early recognition of these factors can guide timely interventions to improve outcomes for severe COVID-19 patients.
Abstract

Keywords:
APACHE II scoreCOVID-19mechanical ventilationplatelet countwhite blood cell

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