Analysis Of Clinical Characteristics And Related Risk Factors In COVID-19 Patients

Background and purpose : As of February 10,2022,the total number of confirmed COVID-19（hereinafter referred to as "COVID-19"）worldwide has reached 400 million,and the number of deaths has exceeded 5.7 million.By retrospective analyzing the clinical characteristics of COVID-19 patients,comparing the clinical characteristics of mild and severe COVID-19 patients and follow-up results,exploring the relevant risk factors of COVID-19 patients.Method:The clinical characteristics of the data of 155 COVID-19 cases admitted to the Second People’s Hospital of Fuyang City,Anhui Province from January 20 to March4,2020 were retrospective analyzed.According to the classification criteria in the COVID-19 treatment program（Trial fifth edition）issued by the National Health Commission,mild and ordinary cases were classified as mild（n=125）,and severe and critical cases were classified as severe（n=30）.We compared the general data,epidemiological history,clinical manifestations,laboratory examination and imaging indicators of the two groups and conducted univariate analysis first,then conducted multivariate Logistic regression analysis on the factors with statistically significant differences in univariate analysis to explore the independent factors influencing the occurrence of severe/critical COVID-19.Results:9 were mild,116 were ordinary,26 were severe,and 4 were critical among the155 confirmed COVID-19 patients.There were 87 males（56.13%）and 68 females（43.87%）.The mean age of patients was（41.95±15.34）years old,and the mean age of patients in the severe group was（50.97±13.55）years old,which was significantly different from that in the mild group（39.78±15.00）years old（P<0.001）.38 patients（24.52%）were complicated with chronic underlying diseases,with hypertension and diabetes being common.The complication rate was higher in severe patients（15 cases,50%）,and the difference was statistically significant compared with mild patients（23cases,18.4%）（P<0.001）.Fever（84.52%）was the most common symptom,and the difference of maximum body temperature between the mild and severe groups was statistically significant（P<0.001）,and patients in the severe group were more likely to have high fever.Other common symptoms were cough,fatigue,tachypnea and diarrhea,among which tachypnea was more common in severe group（P<0.001）.Lymphocyte count decreased in 74 patients（47.74%）,the severity of lymphocyte count reduction was higher in the severe group than in the mild group（P<0.001）.C reactive protein was increased in 100 patients（64.52%）,so as serum amyloid A in 121 patients（78.06%）and interleukin-6 in 104 patients（67.10%）,and the increase was more significant in the severe group（P<0.05）.Among the coagulation indicators,there were 23（14.84%）patients with increased fibrinogen and 34（21.94%）patients with increased D-dimer,with a higher proportion in the severe group.The chest CT of 123 patients（123/146,84.25%）showed bilateral pneumonia,mainly presenting as thin,ground glass or flocculent shadow.Most patients received respiratory support therapy（119/155,76.77%）,and 4 critically ill patients all received invasive mechanical ventilation.All patients were treated with antiviral drugs.A higher proportion of patients in the severe group were immunotreated with glucocorticoids,immunoglobulin,and tozumab compared with those in the mild group.2 critically ill patients were treated with plasmapheresis and artificial liver support.155 patients（100%）have been cured and discharged from hospital,without any death by March 4,2020.The length of hospital stay in these patients ranged from 8 to 43 days,with a median length of 16（14-22）days.Of the 67 patients who were followed up,chest CT returned to normal in most patients during the follow-up period,and a few patients remained with little ground glass shadow and/or fibrotic lesions.Conclusion:In this single-center,retrospective,descriptive study,we found that clinical classification of COVID-19 was dominated by mild,common cases.Ageing and chronic diseases may be the risk factors for deterioration of the disease.Fever is the most common symptom of COVID-19 patients.Shortness of breath during the course of the disease is a warning sign of severe/critical COVID-19 progression.Among inflammatory markers interleukin-6 levels rising sex may be a warning sign of severe/critical COVID-19 progression.The combination of certain laboratory indicators,such as lymphocyte count,C-reactive protein,serum amyloid A and D-dimer levels,may be helpful in determining the severity of the disease,and the combination of these indicators may facilitate the early detection of severe/critical cases.The pulmonary lesions in most patients can return to normal.