Association between clinical manifestations and prognosis in patients with COVID-19

Yu, Tao; Cai, Shaohang; Zheng, Zhidan; Cai, Xuejuan; Liu, Yuanyuan; Yin, Sichun; Peng, Jie; Xu, Xuwen

Abstract Purpose The purpose of this study was to find out risk factors associated with pneumonia, acute respiratory distress syndrome (ARDS) and clinical outcome among patients with 2019 novel coronavirus disease (COVID-19). Methods This was a cross-sectional multicenter clinical study. A total of 95 patients infected with COVID-19 were enrolled. The COVID-19 diagnostic standard was PCR detection of target genes of 2019 novel coronavirus(2019-nCoV). Clinical, laboratory, and radiological results as well as treatment outcome data were obtained. ARDS was defined as oxygenation index (PaO2/FiO2) ≤ 300mmHg. Findings Multivariate analysis showed that older age (OR=1.078, P=0.008) and high BMI (OR=1.327, P=0.024) were independent risk factor associated with patients with pneumonia. For patients with ARDS, multivariate analysis showed that only high systolic blood pressure (SBP) level (OR=1.046, P=0.025) and high lactate dehydrogenase (LDH) level (OR=1.010, P=0.021) were independent risk factors associated with ARDS. A total of 70 patients were conducted CT scan repeatedly after treatment. Patients were divided in disease exacerbation group (n=19) and disease relieve group (n=51). High BMI (OR=1.285, P=0.017) and tobacco smoking (OR=16.13, P=0.032) were independent risk factors associated with disease exacerbation after treatment. Implications Our results help to risk stratification in patients with 2019-nCoV infection. Patients with risk factors should be given timely intervention to avoid disease progression.