Gastrointestinal Infection is the Risk Factor for COVID-19 Inpatients with Assisted Ventilation.

Lei, Ming; Qiu, Yue; Liu, Riguang; Fan, Lixin; Hu, KaiYuan; Lin, Liu; Cao, Jie; Qin, Shuguang; Lei, Chunliang; He, Feng

BACKGROUND The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to prevention and treatment. We aim to describe the clinical characteristics and risk factors of COVID-19 patients needing use assisted ventilation therapy. METHODS In this retrospective cohort study, we included 288 adult inpatients diagnosed with COVID-19 in Guangzhou Eighth People's Hospital. We extracted and compared characteristics between patients using continuous positive airway pressure (CPAP) or not. A binary logistic regression model was used to identify risk factors associated with using CPAP therapy. RESULTS COVID-19 patients with CPAP therapy were older and had higher levels of white blood cells (WBC), procalcitonin (PCT), C-reactive protein (CRP), alanine aminotransferase (ALT), D-dimer, but had lymphopenia. They were also more prone to appear bilateral pneumonia, develop into severe or critically severe cases, and receive ICU admission. Multivariate regression analysis showed that each 1-year increase in age (OR, 1.04; 95%CI, 1.01-1.08; P = 0.013), respiratory rate over 24 times per min (OR, 4.78; 95%CI, 1.08-13.17; P = 0.037), diarrhea (OR, 9.62; 95%CI, 1.57-18.31; P = 0.011), ALT greater than 50 U/L (OR, 6.59; 95%CI, 1.35-15.89; P = 0.003), WBC greater than 10×10⁹/L (OR, 5.42; 95%CI, 2.04-14.75; P = 0.008), PCT greater than 0.05 ng/mL (OR, 7.22; 95%CI, 1.64-18.51; P = 0.018), and CRP greater than 10 mg/L (OR, 8.58; 95%CI, 2.28-20.36; P = 0.030) were risk factors for COVID-19 inpatients with assisted ventilation. CONCLUSION The older age, tachypnea, and gastrointestinal infections showing as diarrhea, elevated ALT, and elevated white blood cells, procalcitonin and C-reactive protein were risk factors for COVID-19 inpatients with assisted ventilation. Investigating and monitoring these factors could help clinicians identify patients with poor prognosis at an early stage and take proactive assisted ventilation to benefit patients.