scholarly journals Clinical characteristics and risk factors for severity of COVID-19 outside Wuhan: a double-center retrospective cohort study of 213 cases in Hunan, China

2020 ◽  
Vol 14 ◽  
pp. 175346662096303
Author(s):  
Xingsheng Hu ◽  
Chunhong Hu ◽  
Yong Yang ◽  
Juan Chen ◽  
Ping Zhong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Creatine Kinase ◽  
Cell Count ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
White Cell Count ◽  
Poor Appetite ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Aim: To investigate clinical characteristics and identify risk factors for severity of coronavirus disease 2019 (COVID-19) pneumonia outside of Wuhan, China. Materials and methods: We included 213 patients with confirmed COVID-19 who had been discharged or died by 15 March 2020. We retrospectively collected epidemiological, clinical, laboratory, computed tomography imaging and outcome data. Clinical characteristics were described and relative risk factors were compared. Results: Most clinical characteristics of this study were similar to those from studies in Wuhan, but there were lower mortality rate and milder severity. The median time from onset of symptoms to confirmation and hospitalization was 4 and 5 days, respectively. The median virus clearance and shedding times were 10 and 15 days, respectively. When the severe/critical group was compared with the mild/moderate group, significant risk factors included: older age; dyspnea; hypertension; poor appetite; fatigue; higher white cell count, neutrophil count, prothrombin time, creatine kinase, creatine kinase-MB, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein; and lower lymphocyte count and albumin ( p < 0.05). In the intensive care unit (ICU) group compared with the non-ICU group, risk factors included: older age; chronic obstructive pulmonary disease (COPD); dyspnea; poor appetite; higher white cell count, D-dimer, ALT, AST and LDH; and lower lymphocyte count and albumin ( p < 0.05). Independent risk factors associated with the severe/critical group were dyspnea [odds ratio (OR) = 19.48], ALT (OR = 6.02) and albumin (OR = 3.36). Independent risk factors associated with the ICU group were dyspnea (OR = 8.88), COPD (OR = 31.80), D-dimer (OR = 8.37), ALT (OR = 28.76) and LDH (OR = 9.95) ( p < 0.05). Conclusion: The severity of COVID-19 outside Wuhan, China was milder than that within Wuhan. The clinical infective period was long, and the longest virus shedding time was 35 days. The most important risk factors were dyspnea, COPD, D-dimer, ALT, LDH and albumin. The reviews of this paper are available via the supplemental material section.

scholarly journals Factors associated with 90-day acute ischemic stroke in patients ≥70 years old with total hip arthroplasty for hip fracture

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui He ◽  
Guoyou Wang ◽  
Ting Li ◽  
Huarui Shen ◽  
LijuanZhang
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Older Age ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background Postoperative ischemic stroke is a devastating complication following total hip arthroplasty (THA). The purpose of the current study was to investigate the incidence of postoperative acute ischemic stroke (AIS) in patients ≥70 years old with THA for hip fracture after 90 days and independent risk factors associated with 90-day AIS. Methods A multicenter retrospective study was conducted, patients ≥70 years old with THA for hip fracture under general anesthesia were included from February 2017 to March 2020. Patients with AIS within 90 days after THA were identified as AIS group; patients with no AIS were identified as no AIS group. The baseline characteristics and risk factors were collected, multivariable logistic regression was used to identify independent risk factors of 90-dayAIS. Results: 2517 patients (mean age 76.18 ± 6.01) were eligible for inclusion in the study. 2.50% (63/2517) of patients had 90-day AIS. Compared with no AIS, older age, diabetes, hyperlipidemia, atrial fibrillation (AF) and higher D-dimer value were more likely in patients with AIS (P < 0.05), and anticoagulant use was fewer in patients with AIS. ROC curve analysis showed that the optimal cut point of D-dimer for AIS was D-dimer≥4.12 μg/ml. Multivariate logistic regression analysis showed that D-dimer≥4.12 μg/ml [adjusted odds ratio (aOR), 4.44; confidence interval (CI), 2.50–7.72; P < 0.001], older age (aOR, 1.08; 95%CI, 1.03–1.12; P < 0.001), hyperlipidemia (aOR, 2.28; 95%CI, 1.25–4.16; P = 0.007), atrial fibrillation (aOR, 5.84; 95% CI, 1.08–15.68; P = 0.001), and diabetes (aOR, 2.60; 95% CI, 1.56–4.39; P < 0.001) were associated with increased risk of 90-day AIS after THA. Conclusions In conclusion, we found that the incidence of 90-day AIS in patients≥70 years old with THA for hip fracture was 2.5%. Older age, diabetes, hyperlipidemia, AF and higher D-dimer value were independent risk factors for 90-day AIS in patients≥70 years old with THA for hip fracture.

scholarly journals Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Blood Cell Count ◽  
Single Centre ◽  
Multiple Factors ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection.MethodsA retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.ResultsOne hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); Body Mass Index (BMI ) ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity.ConclusionDeterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, Oxygen support, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.

scholarly journals Risk Factors and clinical features of deterioration of COVID-19 Patients in Zhejiang, China: a single-centered, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Artificial Liver ◽  
Low Doses ◽  
Blood Cell Count ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract BackgroundA severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection swept through Wuhan and spread across China and overseas from December 2019. To identify predictors associated with disease progression, we evaluate clinical risk factors of exacerbation of SARS-CoV2 infection. Methoda retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019) diagnosed hospitalized cases between January 19, 2019 and February 19, 2020 in Zhejiang, China. We systematically analyzed the clinical characteristics of the patients and predictors of clinical deterioration.Result100 patients with COVID-19 were included, with median age of 54 years. Among them, 49 cases (49%) were severe and critical cases. Age (P=0.0001), gender (P=0.0031), BMI (P=0.0339), hypertension (P<0.0001), IL6 (P=0.0001), IL10 (P<0.0001), T lymphocyte count (P=0.0001), B lymphocyte count (P=0.0001), White blood cell count (P=0.0002), d2 dimer (P=0.005), PCT (P=0.0039), CRP (P<0.0001), AST (P=0.0484) and artificial liver therapy (P=0.0148), glucocorticoid therapy (P<0.0001) were associated with the severity of the disease. Age and overweigh were independent risk factors for disease severity. ConclusionDeterioration among covid-19 infected patients occurred rapidly after hospital admission, it is necessary to pay attention to these patients. In our cohort, we found that several factors resulted in increased severity. Among these factors, Early detection and reversal of these indicators may reduce the progression of the disease. In addition, early treatment with low doses of glucocorticoids and necessary liver therapy may help reduce mortality in critically ill patients.

scholarly journals Assessment of clinical characteristics and mortality-associated factors in COVID-19 Critical cases in Kuwait

2020 ◽  
Author(s):  
Mariam Ayed ◽  
Abdulwahab A Borahmah ◽  
Anwar Yazdani ◽  
Ahmad Sultan ◽  
Ahmad Mossad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Identification ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Clinical Characteristics ◽  
Icu Patients ◽  
Factors Associated ◽  
Predicting Factors ◽  
Infected Adult ◽  
D Dimer

AbstractPurposeTo assess the clinical characteristics and identify mortality predicting factors in intensive care unit (ICU)-admitted COVID-19 confirmed patients.MethodsWe recruited and analyzed COVID-19 infected adult patients (age≥ 18 years) who were admitted to the ICU at Jaber AlAhmad Al Sabah Hospital,Kuwait, between 1stMarch, 2020and 30thApril 2020. The patients were followed up to 20th May, 2020. The risk factors associated with in-hospital mortality were assessed using multiple regression analysis.ResultsWe recruited a total of 103 ICU patients in this retrospective cohort. The median age of the patients was 53 years (Interquartile Range (IQR): 44-63 years). The fatality rate was 43.7%. Among the patients, majority were males (85.5%) and 38% patients had more than two comorbidities. Pre-existing hypertension (OR:3.2,95%CI: 1.2-8.9), moderate/severe ARDS (OR: 3.4, 95%CI: 1.1-10.8),lymphocyte counts <0.5 (OR: 6.1, 95%CI: 1.2-29.8)albumin < 22 (OR: 7.5, 95%CI: 2.1-26.2), procalcitonin >0.2 (OR: 3.8, 95%CI: 1.3-7.8), D-Dimer >1200 (OR: 5.1, 95%CI: 1.2-21.6), and the need forcontinuous renal replacement therapy (OR: 9.3, 95%CI: 2.4-36.2) weresignificantly associated with mortality.ConclusionThis study describes the clinical characteristics and predictors ofmortality among ICU patients. Early identification of risk factors to mortality might help in their better outcome.

scholarly journals Assessment of clinical characteristics and mortality-associated factors in COVID-19 Critical cases in Kuwait

2020 ◽  
Author(s):  
Mariam Ayed ◽  
Abdulwahab A. Borahmah ◽  
Anwar Yazdani ◽  
Ahmad Sultan ◽  
Ahmad Mossad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Identification ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Clinical Characteristics ◽  
Icu Patients ◽  
Factors Associated ◽  
Predicting Factors ◽  
Infected Adult ◽  
D Dimer

Objective To assess the clinical characteristics and identify mortality-predicting factors in intensive care unit (ICU)-admitted COVID-19 confirmed patients. Methods We recruited and analyzed COVID-19 infected adult patients (age≥ 18 years) who were admitted to the ICU at Jaber AlAhmad Al Sabah Hospital, Kuwait, between 1stMarch, 2020 and 30thApril 2020. The patients were followed up to 20th May, 2020. The risk factors associated with in-hospital mortality were assessed using multiple regression analysis. Results We recruited a total of 103 ICU patients in this retrospective cohort. The median age of the patients was 53 years (Interquartile Range (IQR): 44-63 years). The fatality rate was 43.7%. Among the patients, majority were males (85.5%) and 38% patients had more than two comorbidities. Pre-existing hypertension (OR:3.2,95%CI: 1.2-8.9), moderate/severe ARDS (OR: 3.4, 95%CI: 1.1-10.8),lymphocyte counts <0.5 (OR: 6.1, 95%CI: 1.2-29.8)albumin < 22 (OR: 7.5, 95%CI: 2.1-26.2), procalcitonin >0.2 (OR: 3.8, 95%CI: 1.3-7.8), D-Dimer >1200 (OR: 5.1, 95%CI: 1.2-21.6), and the need for continuous renal replacement therapy (OR: 9.3, 95%CI: 2.4-36.2) were significantly associated with mortality. Conclusion This study describes the clinical characteristics and predictors of mortality among ICU patients. Early identification of risk factors to mortality might help in their better outcome.

scholarly journals Development a Nomogram to Predict Prognosis in Severe and Critically Ill Patients with COVID-19

2020 ◽  
Author(s):  
Weiping Tan ◽  
Ying Zhu ◽  
Hui Yi ◽  
Yingyu Lin ◽  
Yumei Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Poor Prognosis ◽  
Total Bilirubin ◽  
Lung Involvement ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background: The number of deaths caused by COVID-19 are on the rising worldwide. This study focused on severe and critically ill COVID-19, aim to explore independent risk factors associated with disease severity and to build a nomogram to predict patients’ prognosis.Methods: Patients with laboratory-confirmed COVID-19 admitted to the Union Hospital, Tongji Medical College and Hankou Hospital of Wuhan, China, from February 8th to April 6th, 2020. LASSO Regression and Multivariate Analysis were applied to screen independent factors. COX Nomogram was built to predict the 7-day, 14-day and 1-month survival probability.Results: A total of 115 severe [73 (63.5%)] and critically ill [42 (36.5%)] patients were included in this study, containing 93 (80.9%) survivors and 22 (19.1%) non-survivors. For disease severity, D-dimer [OR 6.33 (95%CI, 1.27-45.57], eosinophil percentage [OR 8.02 (95%CI, 1.82-45.04)], total bilirubin [OR 12.38 (95%CI, 1.24-223.65)] and lung involvement score [OR 1.22 (95%CI, 1.08-1.40)] were the independent factors associated with critical illness. Troponin [HR 9.02 (95%CI, 3.02, 26.97)] and total bilirubin [HR 3.16 (95%CI, 1.13, 8.85)] were the independent predictors for patients’ prognosis. Troponin≥26.2 ng/L and total bilirubin＞20 μmol/L were associated with poor prognosis. The nomogram based on the independent risk factors had a C-index of 0.92 (95%CI, 0.87, 0.98) for predicting survival probability. The survival nomogram validated in the critically ill patients had a C-index of 0.83 (95%CI: 0.75, 0.94).Conclusions: In conclusion, in severe and critically ill patients with COVID-19, D-dimer, eosinophil percentage, total bilirubin and lung involvement score were the independent risk factors associated with disease severity. The proposed survival nomogram accurately predicted prognosis. The survival analysis may suggest that early incidence of multiple organ dysfunction may be an important predictor of poor prognosis.

scholarly journals Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Blood Cell Count ◽  
Single Centre ◽  
Multiple Factors ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); BMI ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.

scholarly journals Clinical characteristics and prognostic factors of patients with Stenotrophomonas maltophilia infections

2017 ◽  
Vol 9 (02) ◽  
pp. 132-135 ◽  
Author(s):  
Priyam Batra ◽  
Purva Mathur ◽  
Mahesh C. Misra
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Resistance Pattern ◽  
Pathogenic Potential ◽  
Factors Associated ◽  
Venous Catheterization ◽  
Potential Pathogen ◽  
Independent Risk Factors

Abstract INTRODUCTION: Stenotrophomonas maltophilia earlier had limited pathogenic potential, but now with growing degree of immunosuppression in general population, it is being recognized as an important nosocomial pathogen. METHODOLOGY: A retrospective 7 years study was carried out to determine the clinical characteristics of all patients with Stenotrophomonas infections, antibiotic resistance pattern, and risk factors associated with hospital mortality. All patients with Stenotrophomonas culture positivity were identified and their medical records were reviewed. Risk factor associated with hospital mortality was analyzed. RESULTS: A total of 123 samples obtained from 88 patients were culture positive. Most patients presented with bacteremia (45, 51%) followed by pneumonia (37, 42%) and skin and soft tissue infections (6, 7%). About 23 of 88 Stenotrophomonas infected patients had co-infection. Percentage resistance to cotrimoxazole; 8 (5.4%) was lower than that for levofloxacin; 18 (12%). Twenty-eight patients died during hospital stay. Intensive Care Unit admission (P = 0.0002), mechanical ventilation (P = 0.0004), central venous catheterization (P = 0.0227), urethral catheterization (P = 0.0484), and previous antibiotic intake (P = 0.0026) were independent risk factors associated with mortality. CONCLUSION: Our findings suggest that Stenotrophomonas can cause various infections irrespective of patient’s immune status and irrespective of potential source. Thus, Stenotrophomonas should be thought of as potential pathogen and its isolation should be looked with clinical suspicion.

scholarly journals Clinical characteristics and risk factors of patients with severe COVID-19 in Jiangsu province, China

2020 ◽  
Author(s):  
Songqiao Liu ◽  
Huanyuan Luo ◽  
Yuancheng Wang ◽  
Luis E. Cuevas ◽  
Duolao Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Lymphocyte Count ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Jiangsu Province ◽  
Factors Associated ◽  
Radiological Data ◽  
Multivariable Regression

Abstract BackgroundTo describe the characteristics of patients with Coronavirus Disease-2019 (COVID-19) and factors associated with severe or critically ill presentation.MethodsMulticentre retrospective cohort study of all individuals with confirmed Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) infections diagnosed at 24 COVID-19-designated hospitals in Jiangsu province between the 10th January and 15th March 2020. Demographic, clinical, laboratory, and radiological data were collected at hospital admission and data on disease severity were collected at from admission. Patients were categorised as asymptomatic/mild/moderate, and severe/critically ill according to the worst level of COVID-19 recorded during hospitalisation.ResultsA total of 625 patients, 64 (10.2%) were severe/critically ill and 561 (89.8%) were asymptomatic/mild/moderate. All patients were discharged and no patients died. Multivariable regression showed that odds of being a severe/critically ill case were associated with age (year) (OR, 95%CI 1.06, 1.03–1.09), lymphocyte count (109/L) (OR 0.25, 0.08–0.74), and pulmonary opacity in CT (per 5%) on admission (OR 1.31, 95%CI 1.15–1.51).ConclusionsSevere or critically ill patients with COVID-19 is about one-tenths of patients in Jiangsu. Age, lymphocyte count, and pulmonary opacity in CT on admission were associated with risk of severe or critically ill COVID-19.# Songqiao Liu, Huanyuan Luo, Yuancheng Wang contributed equally to this manuscript

scholarly journals Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study

2020 ◽  
Author(s):  
Ping Yi ◽  
Xiang Yang ◽  
Cheng Ding ◽  
Yanfei Chen ◽  
Kaijin Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
B Lymphocyte ◽  
Blood Cell Count ◽  
Single Centre ◽  
Multiple Factors ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); BMI ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, Oxygen support, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.

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