Predictors for Severe COVID-19 Infection - PubMed (original) (raw)
Observational Study
. 2020 Nov 5;71(8):1962-1968.
doi: 10.1093/cid/ciaa674.
Affiliations
- PMID: 32472676
- PMCID: PMC7314166
- DOI: 10.1093/cid/ciaa674
Observational Study
Predictors for Severe COVID-19 Infection
Ashish Bhargava et al. Clin Infect Dis. 2020.
Abstract
Background: COVID-19 is a pandemic disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Predictors for severe COVID-19 infection have not been well defined. Determination of risk factors for severe infection would enable identifying patients who may benefit from aggressive supportive care and early intervention.
Methods: We conducted a retrospective observational study of 197 patients with confirmed COVID-19 admitted to a tertiary academic medical center.
Results: Of 197 hospitalized patients, the mean (SD) age of the cohort was 60.6 (16.2) years, 103 (52.3%) were male, and 156 (82.1%) were black. Severe COVID-19 infection was noted in 74 (37.6%) patients, requiring intubation. Patients aged above 60 were significantly more likely to have severe infection. Patients with severe infection were significantly more likely to have diabetes, renal disease, and chronic pulmonary disease and had significantly higher white blood cell counts, lower lymphocyte counts, and increased C-reactive protein (CRP) than patients with nonsevere infection. In multivariable logistic regression analysis, risk factors for severe infection included pre-existing renal disease (odds ratio [OR], 7.4; 95% CI, 2.5-22.0), oxygen requirement at hospitalization (OR, 2.9; 95% CI, 1.3-6.7), acute renal injury (OR, 2.7; 95% CI, 1.3-5.6), and CRP on admission (OR, 1.006; 95% CI, 1.001-1.01). Race, age, and socioeconomic status were not independent predictors.
Conclusions: Acute or pre-existing renal disease, supplemental oxygen upon hospitalization, and admission CRP were independent predictors for the development of severe COVID-19. Every 1-unit increase in CRP increased the risk of severe disease by 0.06%.
Keywords: predictors; risk factors; severe COVID-19.
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
Comment in
- Nasopharyngeal SARS-CoV-2 Load at Hospital Admission as a Predictor of Mortality.
Alteri C, Cento V, Vecchi M, Colagrossi L, Fanti D, Vismara C, Puoti M, Perno CF; SCoVA Study Group. Alteri C, et al. Clin Infect Dis. 2021 May 18;72(10):1868-1869. doi: 10.1093/cid/ciaa956. Clin Infect Dis. 2021. PMID: 32674129 Free PMC article. No abstract available. - Reply to Alteri et al.
Bhargava A, Fukushima EA, Levine M, Zhao W, Tanveer F, Szpunar SM, Saravolatz L. Bhargava A, et al. Clin Infect Dis. 2021 May 18;72(10):1870. doi: 10.1093/cid/ciaa960. Clin Infect Dis. 2021. PMID: 32674132 No abstract available.
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