Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020.

ABSTRACT: BackgroundIn March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization.AimOur objective was to identify risk factors predictive of severe disease and death in France.MethodsIn this prospective cohort study, we included patients???18?years old with confirmed COVID-19, hospitalised in Strasbourg and Mulhouse hospitals (France), in March 2020. We respectively compared patients who developed severe disease (admission to an intensive care unit (ICU) or death) and patients who died, to those who did not, by day?7 after hospitalisation.ResultsAmong 1,045 patients, 424 (41%) had severe disease, including 335 (32%) who were admitted to ICU, and 115 (11%) who died. Mean age was 66?years (range:?20-100), and 612 (59%) were men. Almost 75% of patients with body mass index (BMI) data (n?=?897) had a BMI???25?kg/m2 (n?=?661). Independent risk factors associated with severe disease were advanced age (odds ratio (OR):?1.1 per?10-year increase; 95%?CrI (credible interval):?1.0-1.2), male sex (OR:?2.1;?95%?CrI:?1.5-2.8), BMI of 25-29.9?kg/m2 (OR:?1.8;?95%?CrI:?1.2-2.7) or???30 (OR:?2.2;?95%?CrI:?1.5-3.3), dyspnoea (OR:?2.5;?95%?CrI:?1.8-3.4) and inflammatory parameters (elevated C-reactive protein and neutrophil count, low lymphocyte count). Risk factors associated with death were advanced age (OR:?2.7 per?10-year increase;?95%?CrI:?2.1-3.4), male sex (OR:?1.7;?95%?CrI:?1.1-2.7), immunosuppression (OR:?3.8;?95%?CrI:?1.6-7.7), diabetes (OR:?1.7;?95%?CrI:?1.0-2.7), chronic kidney disease (OR:?2.3;?95%?CrI:?1.3-3.9), dyspnoea (OR:?2.1;?95%?CrI:?1.2-3.4) and inflammatory parameters.ConclusionsOverweightedness, obesity, advanced age, male sex, comorbidities, dyspnoea and inflammation are risk factors for severe COVID-19 or death in hospitalised patients. Identifying these features among patients in routine clinical practice might improve COVID-19 management.

SUBMITTER: Kaeuffer C 

PROVIDER: S-EPMC7716399 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature