BMC Infectious Diseases (Sep 2021)
Clinical characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, China
- Meng Jin,
- Zequn Lu,
- Xu Zhang,
- Yanan Wang,
- Jing Wang,
- Yimin Cai,
- Kunming Tian,
- Zezhong Xiong,
- Qiang Zhong,
- Xiao Ran,
- Chunguang Yang,
- Xing Zeng,
- Lu Wang,
- Yao Li,
- Shanshan Zhang,
- Tianyi Dong,
- Xinying Yue,
- Heng Li,
- Bo Liu,
- Xin Chen,
- Hongyuan Cui,
- Jirong Qi,
- Haining Fan,
- Haixia Li,
- Xiang-Ping Yang,
- Zhiquan Hu,
- Shaogang Wang,
- Jun Xiao,
- Ying Wang,
- Jianbo Tian,
- Zhihua Wang
Affiliations
- Meng Jin
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University
- Zequn Lu
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology
- Xu Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
- Yanan Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Jing Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Yimin Cai
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology
- Kunming Tian
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology
- Zezhong Xiong
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Qiang Zhong
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Xiao Ran
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Chunguang Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Xing Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Lu Wang
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology
- Yao Li
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology
- Shanshan Zhang
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology
- Tianyi Dong
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology
- Xinying Yue
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology
- Heng Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Bo Liu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Xin Chen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Hongyuan Cui
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
- Jirong Qi
- Department of Cardiothoracic Surgery, Nanjing Children’s Hospital Affiliated to Nanjing Medical University
- Haining Fan
- Department of General Surgery, Qinghai University Affiliated Hospital
- Haixia Li
- Computer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Xiang-Ping Yang
- Department of Immunology, Tongji Medical College, Huazhong University of Science and Technology
- Zhiquan Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Jun Xiao
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Ying Wang
- Department of Virology, Wuhan Centers for Disease Prevention and Control
- Jianbo Tian
- School of Health Sciences, Wuhan University
- Zhihua Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- DOI
- https://doi.org/10.1186/s12879-021-06585-8
- Journal volume & issue
-
Vol. 21,
no. 1
pp. 1 – 13
Abstract
Abstract Background The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted. Methods In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020. Results Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19. Conclusions The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.
Keywords