Retrospective study of risk factors for severe SARS-Cov-2 infections in hospitalized adult patients.

Yao, Qingchun; Wang, Peng; Wang, Xingguang; Qie, Guoqiang; Meng, Mei; Tong, Xiwen; Bai, Xue; Ding, Min; Liu, Weiming; Liu, Keke; Chu, Yufeng

INTRODUCTION Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been spread worldwide. OBJECTIVES To identify the clinical characteristics and risk factors associated with the severe incidence of SARS-CoV-2 infection. PATIENTS AND METHODS All adult patients (≥18 years old) consecutively admitted in Dabieshan Medical Center from January 30, 2020 to February 11, 2020 were collected and reviewed. Only patients diagnosed with COVID-19 according to WHO interim guidance were included in this retrospective cohort study. RESULTS A total of 108 patients with COVID-19 were retrospectively analyzed. Twenty-five patients (23.1%, 25/108) developed severe disease, and of those 12 (48%, 12/25) patients died. Advanced age, co-morbidities with hypertension, higher blood leukocyte count, neutrophil count, higher sensitive C-reactive protein level, D-dimer level, Acute Physiology and Chronic Health Evaluation Ⅱ (APECHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score were associated with greater risk of development of severe COVID-19, and so were lower lymphocyte count and albumin level. Multivariable regression showed increasing odds of severe COVID-19 associated with higher SOFA score (OR 2.450, 1.302-4.608; p = 0.005), and lymphocyte count less than 0.8×109 per L (OR 9.017, 2.808-28.857; p <0.001) on admission. The higher SOFA score (OR 2.402, 1.313-4.395; p = 0.004) on admission was identified as risk factor for in-hospital death. CONCLUSIONS Lymphocytopenia and the higher SOFA score on admission could help clinicians to identify patients with high risk for developing severe COVID-19. More related studies are needed in the future.