Clinical features and risk factors associated with severe COVID-19 patients in China

Abstract

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.

Virtual reality-based rehabilitation in patients following total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials

“…[ 7 ] In addition, the coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the health care system. [ 8 ] Face-to-face post-operative rehabilitation has become inaccessible during the pandemic, which has led to the rapid development of contactless methods of rehabilitation. [ 9 ] By delivering medical care at a distance, telehealth and virtual reality (VR) are increasingly regarded as potentially effective health-care interventions.…”

“…The post-operative rehabilitation program following TKA has mainly shifted toward outpatient and community over the past decade in the United States [7] . In addition, the coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the health care system [8] . Face-to-face post-operative rehabilitation has become inaccessible during the pandemic, which has led to the rapid development of contactless methods of rehabilitation [9] .…”

The Role of Surface in the Pathogenesis and Treatment of COVID-19

“…Persons with low ambient levels of SP-D, i.e., smokers [38], the obese [39], or the pregnant [40], should be most susceptible to severe COVID-19 [41][42][43]. Moreover, because youths have larger intracellular and alveolar surfactant pools, as well as a much higher rate of SP-D recycling compared to the elderly [44], advanced age, too, should be a risk factor for disease severity [45].…”

For the health of the people—commemorating the 135th anniversary of the founding of the Chinese Medical Journal

“…[51] Since the outbreak of COVID-19 in 2019, medical scientists have performed in-depth research on the clinical characteristics of patients, the time and risk factors of viral clearance, developed experts' consensus, and have made important progress. [52][53][54] Throughout the 135-year history of the Chinese Medical Journal, the journal has not only witnessed tremendous changes in the health status of the Chinese people, but has also shown important contributions made by Chinese medical scientists in studying disease and health issues. With reflection on the past, the development of modern medicine in China has evolved, from the introduction of Western medicine to the present day, when China also has assumed its responsibility for the global health cause and played a vital role in solving global health concerns.…”

“…Nanshan Zhong et al compiled an expert consensus on the management of severe acute respiratory syndrome [51] . Since the outbreak of COVID-19 in 2019, medical scientists have performed in-depth research on the clinical characteristics of patients, the time and risk factors of viral clearance, developed experts’ consensus, and have made important progress [52–54] …”