Coronavirus disease 2019-associated pneumonia: risk factors and predictors of severity

Abstract

Context Since the emerging coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, it has spread aggressively around the world. There is the need to perform several studies from different populations to identify the risk factors. Aims To distinguish patients at risk of severe COVID-19-associated pneumonia and to identify early clinical and laboratory predictors for severe pneumonia. Patients and methods This is a retrospective cohort study of patients with confirmed COVID-19. Patient data including demographic, clinical, laboratory, and radiological were collected from stored computer data and patients’ medical records. Clinically, in this study patients have been classified into severe and nonsevere patients. Results Out of 108 included patients, 57 were severe cases. Obesity was also an independent risk factor of severity in age less than 60 years. Inflammatory indices [C-reactive protein (CRP), D-dimer, ferritin) were also significantly elevated in the severe group at initial presentation (P<0.001, 0.001, 0.001, respectively). The optimum cutoff of CRP, D-dimer, and ferritin to predict COVID-19 severity was more than or equal to 20.76 mg/l, more than or equal to 0.51 μg/ml, and more than or equal to 338.25 ng/l, respectively. Conclusion Male sex, old age, obesity, and multiple comorbidities are independent risk factors for COVID-19-associated severe pneumonia. Elevated inflammatory indices (CRP, D-dimer, and ferritin) are independent laboratory predictors for COVID-19 severity. So careful monitoring of male, obese, and old age with multiple comorbidities with regular monitoring of inflammatory markers is recommended.

Keywords

• coronavirus disease 2019
• risk factors
• severe pneumonia