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Risk factors for adverse clinical outcomes with COVID-19 in China: a multicenter, retrospective, observational study

机译:中国Covid-19不利临床结果的危险因素:多中心,回顾,观测研究

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Background: The risk factors for adverse events of Coronavirus Disease-19 (COVID-19) have not been well described. We aimed to explore the predictive value of clinical, laboratory and CT imaging characteristics on admission for short-term outcomes of COVID-19 patients. Methods: This multicenter, retrospective, observation study enrolled 703 laboratory-confirmed COVID-19 patients admitted to 16 tertiary hospitals from 8 provinces in China between January 10, 2020 and March 13, 2020. Demographic, clinical, laboratory data, CT imaging findings on admission and clinical outcomes were collected and compared. The primary endpoint was in-hospital death, the secondary endpoints were composite clinical adverse outcomes including in-hospital death, admission to intensive care unit (ICU) and requiring invasive mechanical ventilation support (IMV). Multivariable Cox regression, Kaplan-Meier plots and log-rank test were used to explore risk factors related to in-hospital death and in-hospital adverse outcomes. Results: Of 703 patients, 55 (8%) developed adverse outcomes (including 33 deceased), 648 (92%) discharged without any adverse outcome. Multivariable regression analysis showed risk factors associated with in-hospital death included ≥ 2 comorbidities (hazard ratio [HR], 6.734; 95% CI; 3.239-14.003, p 14 (HR, 2.915; 95% CI, 1.376-6.177, p = 0.005) on admission, while older age (HR, 2.231; 95% CI, 1.124-4.427, p = 0.022), ≥ 2 comorbidities (HR, 4.778; 95% CI; 2.451-9.315, p 14 (HR, 1.946; 95% CI; 1.095-3.459, p = 0.023) were associated with increased odds of composite adverse outcomes. Conclusion: The risk factors of older age, multiple comorbidities, leukocytosis, lymphopenia and higher CT severity score could help clinicians identify patients with potential adverse events.? The author(s).
机译:背景:为冠状病毒病-19(COVID-19)没有得到很好的描述不良事件的危险因素。我们的目的是探讨入场COVID-19例的短期结果的临床,实验室和CT成像特性的预测值。方法:多中心,回顾性,观察研究纳入了703例实验室确诊COVID-19例2020 1月10日和3月13日到2020年人口学,临床,实验室数据,CT成像上发现间收治16家三级医院在中国8个省入场和临床结果收集和比较。主要终点是在医院死亡,次级终点是临床复合不良结果包括在医院死亡,入院到重症监护病房(ICU),并且需要有创机械通气支持(IMV)。多变量Cox回归,的Kaplan-Meier曲线和对数秩检验来探讨有关在医院死亡和在医院不良后果的危险因素。结果:703例患者,55(8%)显影不良后果(包括33已故),648(92%)而没有任何不利的结果排出。与院内死亡相关的多变量回归分析显示危险因素包括≥2合并症(危险比(HR),6.734; 95%CI; 3.239-14.003,第14页(HR,2.915; 95%CI,1.376-6.177,P = 0.005)入院,而较早的年龄(HR,2.231; 95%CI,1.124-4.427,p = 0.022),≥2个合并症(HR,4.778; 95%CI; 2.451-9.315,第14页(HR,1.946; 95 %CI,1.095-3.459,p = 0.023)与增加复合不良后果的可能性相关的结论:年龄大,合并症多,白细胞增多,淋巴细胞和更高的CT严重程度评分的危险因素可以帮助医生确定患者的潜在不良事件。 ?笔者(S)。
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