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Background: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. In this study, we aimed to identify the risk factors for severe COVID-19 to improve treatment guidelines. Methods: A multicenter, cross-sectional study was conducted on 313 patients hospitalized with COVID-19. Patients were classified into two groups based on disease severity (nonsevere and severe) according to initial clinical presentation. Laboratory test results and epidemiological and clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression models were used to detect potential risk factors associated with severe COVID-19. Results: A total of 289 patients (197 nonsevere and 92 severe cases) with a median age of 45.0 (33.0, 61.0) years were included in this study, and 53.3% (154/289) were male. Fever (192/286, 67.1%) and cough (170/289, 58.8%) were commonly observed, followed by sore throat (49/289, 17.0%). Multivariate logistic regression analysis suggested that patients who were aged ≥ 65 years (OR: 2.725, 95% confidence interval [CI]: 1.317–5.636; P = 0.007), were male (OR: 1.878, 95% CI: 1.002–3.520, P = 0.049), had comorbid diabetes (OR: 3.314, 95% CI: 1.126–9.758, P = 0.030), cough (OR: 3.427, 95% CI: 1.752–6.706, P < 0.001), and/or diarrhea (OR: 2.629, 95% CI: 1.109–6.231, P = 0.028) on admission had a higher risk of severe disease. Moreover, stratification analysis indicated that male patients with diabetes were more likely to have severe COVID-19 (71.4% vs. 28.6%, χ 2 = 8.183, P = 0.004). Conclusions: The clinical characteristics of those with severe and nonsevere COVID-19 were significantly different. The elderly, male patients with COVID-19, diabetes, and presenting with cough and/or diarrhea on admission may require close monitoring to prevent deterioration.

ObjectiveTo investigate the presence of previously undiagnosed radiographic bronchiectasis in stable chronic obstructive pulmonary disease (COPD) patients using high resolution computed tomography (HRCT) and to evaluate the effect of radiographic bronchiectasis on the symptoms and risks in stable COPD patients.MethodsFrom May 2012 to April 2014, there were 347 patients enrolled in COPD database. Data describing the general conditions, the frequency of acute exacerbations the year before, COPD assessment test, modified medical research council (mMRC) score, spirometric classification, and HRCT were collected. COPD patients were classified into two groups: COPD with bronchiectasis and COPD without bronchiectasis. The clinical characteristics of both groups were compared.ResultsBronchiectasis was presented in 18.4% (n = 64). The proportion of smokers, smoking index, and forced expiratory volume in 1 second predicted value were 62.5%, 27.3 ± 13.2, 48.2 ± 26.4, respectively, in the bronchiectasis group, which were lower than those of the group without bronchiectasis (82.0%, 32.6 ± 17.6, and 57.9 ± 18.8) (P < 0.05). Complications, COPD assessment test (CAT) and the rate of CAT ≥ 10 in the bronchiectasis group were 2.8 ± 1.7,13.6 ± 7.4 and 26.6%, respectively, which were higher than those of the group without bronchiectasis (2.3 ± 1.5,11.3 ± 6.0, and 11.7%) (P < 0.05). The proportion of type D (high-risk more-symptoms) in the bronchiectasis group was 50.0%; it was significantly higher than that of 35.7% in the group without bronchiectasis (P < 0.05).ConclusionsCOPD with bronchiectasis is associated with more complications, symptoms, and risks. More attention should be paid to the treatment of COPD with bronchiectasis to reduce the frequency of exacerbation and improve the health status.

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