16 June COVID-19 With Different Severities: A Multicenter Study of Clinical Features
Yun Feng, Yun Ling, Tao Bai, Yusang Xie, Jie Huang, Jian Li, Weining Xiong, Dexiang Yang, Rong Chen, Fangying Lu, Yunfei Lu, Xuhui Liu, Yuqing Chen, Xin Li, Yong Li, Hanssa Dwarka Summah, Huihuang Lin, Jiayang Yan, Min Zhou, Hongzhou Lu, and Jieming Qu
ABSTRACT
Justification:
The coronavirus disease (COVID-19) pandemic is now a global health issue.
Objectives:
The clinical characteristics, laboratory examinations, CT images, and treatments of COVID-19 patients from three different cities in China were compared.
Methods:
A total of 476 patients were recruited from January 1, 2020 to February 15, 2020 in three hospitals in Wuhan, Shanghai, and Anhui. The patients were divided into four groups according to age and three groups (moderate, severe and critical) according to the fifth edition of the Guidelines on the Diagnosis and Treatment of COVID-19 issued by the National Health Commission of China.
Main results:
- The incidence of comorbidities was higher in the severe (46,3%) and critical (67,1%) groups than in the moderate group (37,8%).
- More patients were taking angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers in the moderate group than in the severe and critical groups.
- More patients had multiple lung lobe involvement and pleural effusion in the critical group than in the moderate group.
- More patients received antiviral agents within the first 4 days in the moderate group than in the severe group
- More patients received antibiotics and corticosteroids in the critical and severe groups.
- Patients > 75 years of age had a significantly lower survival rate than younger patients.
Conclusions:
Multiple organ dysfunction and impaired immune function were typical features of patients with severe or critical illness. There was a significant difference in the use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers between patients with different degrees of disease. Involvement of multiple lung lobes and pleural effusion were associated with COVID-19 severity. Advanced age (≥75 years) was a risk factor for mortality.