Abstract：Objective To analyze the risk factors of occurring severe and critical coronavirus disease 2019 (COVID-19), and to provide a basis for early predicting the progress from light and common COVID-19 to severe and critical conditions. Methods We collected the data about general, epidemiological, clinical and laboratory information of COVID-19 confirmed cases hospitalized in the First Hospital of Changsha City from January 17 to March 14 in 2020. Retrospective cohort analysis was applied to analyzing the risk factors of occurring severe and critical COVID-19. Single-factor Chi-square test and multivariate logistic regression were used to analyze the relevant indicators. Results One hundred and sixty-nine patients were included in this study, including 136 light and common cases and 33 severe and critical cases. Single factor analysis showed that there were statistically significant differences in age, having a history of alcohol consumption, having the infection in Hubei Province, having an explicit contact history, complicating with chronic heart disease, hypertension, total protein (TP), albumin, lymphocyte, blood glucose, lactate dehydrogenase, procalcitonin (PCT) and C-reactive protein (CRP) between light and common cases and severe and critical cases (all P<0.05). Multivariate logistic regression analysis indicated that having a history of alcohol consumption (OR=3.06), having chronic heart disease (OR=15.26), low TP level(OR=2.13), elevated blood glucose level on admission (OR=4.91) and elevated CRP level(OR=12.34)were independent risk factors for severe and critical COVID-19 (P<0.05). Conclusions Having a history of alcohol consumption, having chronic heart disease, low TP, high blood glucose and high CRP levels on admission are risk factor for severe and critical COVID-19. The results suggest that physicians should payspecial attention to light and common patients with COVID-19 having the above-mentioned factors.
[1] Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019[J]. N Engl J Med, 2020, 382(8):727-733. [2] 国家卫生健康委员会办公厅,国家中医药管理局办公室. 新型冠状病毒感染的肺炎诊疗方案(试行第四版)[Z]. 2020-01-27. [3] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223):497-506. [4] Chen N,Zhou M,Dong X,et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study[J]. Lancet, 2020, 395(10223):507-513. [5] 程克斌,魏明,沈虹,等.普通型和重型新型冠状病毒肺炎康复患者463例临床特征分析[J].上海医学, 2020, 15(4):1-15. [6] 胡世雄,徐巧华,罗垲炜,等.湖南省新型冠状病毒肺炎感染者流行病学特征分析[J]. 实用预防医学,2020,27(4):385-388. [7] 李丹, 龙云铸, 黄彭, 等. 株洲地区80例新型冠状病毒肺炎患者临床特征分析[J]. 中国感染控制杂志, 2020, 19(3):227-233. [8] Wang D,Hu B,Hu C,et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China[J]. JAMA, 2020, 323(11):1061-1069. [9] Wang JL, Lu XY, Xu XH, et al. Predictive role of monocyte-to-lymphocyte ratio in patients with Klebsiella pneumonia infection: a single-center experience[J]. Medicine(Baltimore), 2019, 98(38):e17215.[10] 刘发生, 邹忠玉,吴玉成,等. 开颅术后颅内感染患者血清PCT、CRP、IFN-γ变化及临床意义[J]. 中华医院感染学杂志, 2020, 30(7):1021-1024. [11] Guo XJ, Thomas PG. New fronts emerge in the influenza cytokine storm[J]. Semin Immunopathol, 2017, 39(5):541-550. [12] 彭文艺, 甘雪晴, 谭艳, 等. 新型冠状病毒感染性疾病心血管系统损害机制与治疗进展[J]. 中华医院感染学杂志, 2020, 30(8):1177-1182. [13] Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome [J]. Lancet Respir Med, 2020, 8(4):420-422. [14] 荣义辉, 常伟华, 刘艳平, 等. SARS患者心脏、肾脏等肺外器官损害及其临床意义—附330例临床分析[J]. 第二军医大学学报, 2003,30(8):813-816. [15] Oudit GY, Kassiri Z, Jiang C, et al. SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS[J]. Eur J Clin Invest, 2009, 39(7):618-625. [16] 谭明万. 湖南健康人群血清蛋白质和血糖调查及相关因素研究[D].长沙:中南大学, 2011. [17] Fragopoulou E, Choleva M, Antonopoulou S, et al. Wine and its metabolic effects. A comprehensive review of clinical trials[J]. Metabolism, 2018, 24(1):102-119. [18] Mauricio D, Alonso N, Gratacòs M. Chronic diabetes complications: the need to move beyond classical concepts[J]. Trends Endocrinol Metab, 2020, 31(4):287-295. [19] Wang A, Zhao W, Xu Z, et al. Timely blood glucose management for the outbreak of 2019 novel coronavirus disease (COVID-19) is urgently needed[J]. Diabetes Res Clin Pract, 2020, 16(2):108-118.
2021, Vol. 28 
