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Research article
Yadong Yuan
The Second Hospital of Hebei Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1319-4743
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Due to the latent onset of novel coronavirus disease 2019 (COVID-19), it is important to identify patients with increased probabilities for disease progression early in order to implement timely medical strategies. This study aimed to identify the factors associated with severe COVID-19 and evaluate the current antiviral drugs, especially in severe patients.
Methods
This was a retrospective observational study performed at the No. 7 Hospital of Wuhan (Wuhan, China) with hospitalized patients confirmed with COVID-19 from January 11 to March 13, 2020. Multivariable logistic regression analysis was used to identify the associated factors of severe COVID. Treatment of antivirus drugs were collected and evaluated.
Results
Of the 550 patients, 292 (53.1%) were female and 277 (50.4%) were ≥ 60 years old. The most common symptom was fever (n = 372, 67.7%), followed by dry cough (n = 257, 46.7%), and dyspnea (n = 237, 43.1%), and fatigue (n = 224, 40.7%). Among the severe patients, 20.2% required invasive ventilator support and 18.0% required non-invasive ventilator. The identified risk factors for severe cases were: age ≥ 60 years (odds ratio (OR) = 3.02, 95% confidence interval (CI): 1.13–8.08, P = 0.028), D-dimer > 0.243 µg/ml (OR = 2.734, 95%CI: 1.012–7.387, P = 0.047), and low oxygenation index (OR = 0.984, 95%CI: 0.980–0.989, P < 0.001). In severe cases, the benefits of arbidol alone was 73.3%, which was better than ribavirin (7/17, 41.2%, P = 0.029).
Conclusions
Age ≥ 60 years, D-dimer > 0.243 µg/ml, and lower oxygenation index were associated with severe cases. Arbidol might provide more clinical benefits in treating patients with severe COVID-19 compared with other antiviral drugs.
Keywords
COVID-19, SARS-CoV-2, disease severity, associated factors, antiviral drug
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The most recent version of this article is available here.
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Editorial decision: Minor revision
On 21 Jan, 2021
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Review #3 received
Received 04 Jan, 2021
Reviewer #4 agreed
On 15 Dec, 2020
Reviewer #3 agreed
On 14 Dec, 2020
Review #2 received
Received 21 Nov, 2020
Review #1 received
Received 14 Nov, 2020
Reviewer #2 agreed
On 07 Nov, 2020
Editor assigned
On 02 Nov, 2020
Reviewers invited
Invitations sent on 02 Nov, 2020
Reviewer #1 agreed
On 02 Nov, 2020
Submission checks complete
On 02 Nov, 2020
Editor invited
On 02 Nov, 2020
Version 1
Posted 14 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 13 Oct, 2020
Review #3 received
Received 10 Oct, 2020
Review #2 received
Received 10 Oct, 2020
Review #1 received
Received 04 Oct, 2020
Reviewer #2 agreed
On 19 Sep, 2020
Reviewer #3 agreed
On 19 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Editor assigned
On 03 Sep, 2020
First submitted
On 02 Sep, 2020
Submission checks complete
On 02 Sep, 2020
Editor invited
On 02 Sep, 2020
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Subject Areas
Critical Care & Emergency Medicine
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This preprint is under consideration at BMC Infectious Diseases. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yadong Yuan
The Second Hospital of Hebei Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1319-4743
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
The most recent version of this article is available here.
No community comments so far
Editorial decision: Minor revision
On 21 Jan, 2021
Review #4 received
Received 04 Jan, 2021
Review #3 received
Received 04 Jan, 2021
Reviewer #4 agreed
On 15 Dec, 2020
Reviewer #3 agreed
On 14 Dec, 2020
Review #2 received
Received 21 Nov, 2020
Review #1 received
Received 14 Nov, 2020
Reviewer #2 agreed
On 07 Nov, 2020
Editor assigned
On 02 Nov, 2020
Reviewers invited
Invitations sent on 02 Nov, 2020
Reviewer #1 agreed
On 02 Nov, 2020
Submission checks complete
On 02 Nov, 2020
Editor invited
On 02 Nov, 2020
Version 1
Posted 14 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 13 Oct, 2020
Review #3 received
Received 10 Oct, 2020
Review #2 received
Received 10 Oct, 2020
Review #1 received
Received 04 Oct, 2020
Reviewer #2 agreed
On 19 Sep, 2020
Reviewer #3 agreed
On 19 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Editor assigned
On 03 Sep, 2020
First submitted
On 02 Sep, 2020
Submission checks complete
On 02 Sep, 2020
Editor invited
On 02 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background
Due to the latent onset of novel coronavirus disease 2019 (COVID-19), it is important to identify patients with increased probabilities for disease progression early in order to implement timely medical strategies. This study aimed to identify the factors associated with severe COVID-19 and evaluate the current antiviral drugs, especially in severe patients.
Methods
This was a retrospective observational study performed at the No. 7 Hospital of Wuhan (Wuhan, China) with hospitalized patients confirmed with COVID-19 from January 11 to March 13, 2020. Multivariable logistic regression analysis was used to identify the associated factors of severe COVID. Treatment of antivirus drugs were collected and evaluated.
Results
Of the 550 patients, 292 (53.1%) were female and 277 (50.4%) were ≥ 60 years old. The most common symptom was fever (n = 372, 67.7%), followed by dry cough (n = 257, 46.7%), and dyspnea (n = 237, 43.1%), and fatigue (n = 224, 40.7%). Among the severe patients, 20.2% required invasive ventilator support and 18.0% required non-invasive ventilator. The identified risk factors for severe cases were: age ≥ 60 years (odds ratio (OR) = 3.02, 95% confidence interval (CI): 1.13–8.08, P = 0.028), D-dimer > 0.243 µg/ml (OR = 2.734, 95%CI: 1.012–7.387, P = 0.047), and low oxygenation index (OR = 0.984, 95%CI: 0.980–0.989, P < 0.001). In severe cases, the benefits of arbidol alone was 73.3%, which was better than ribavirin (7/17, 41.2%, P = 0.029).
Conclusions
Age ≥ 60 years, D-dimer > 0.243 µg/ml, and lower oxygenation index were associated with severe cases. Arbidol might provide more clinical benefits in treating patients with severe COVID-19 compared with other antiviral drugs.
Figure 1
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