Risk factors for disease severity,unimprovement, and mortality in COVID-19 patients in Wuhan,China

ObjectiveIn December 2019, coronavirus disease (COVID-19) emerged in Wuhan. However, the characteristics and risk factors associated with disease severity, unimprovement and mortality are unclear and our objective is to throw some light on these.MethodsAll consecutive patients diagnosed with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 11 to February 6, 2020, were enrolled in this retrospective cohort study.ResultsA total of 663 COVID-19 patients were included in this study. Among these, 247 (37.3%) had at least one kind of chronic disease; 0.5% of the patients (n = 3) were diagnosed with mild COVID-19, while 37.8% (251/663), 47.5% (315/663), and 14.2% (94/663) were in moderate, severe, and critical conditions, respectively. In our hospital, during follow-up 251 of 663 patients (37.9%) improved and 25 patients died, a mortality rate of 3.77%. Older patients (>60 years old) and those with chronic diseases were prone to have a severe to critical COVID-19 condition, to show unimprovement, and to die (p <0.001, <0.001). Multivariate logistic regression analysis identified being male (OR = 0.486, 95%CI 0.311–0.758; p 0.001), having a severe COVID-19 condition (OR = 0.129, 95%CI 0.082–0.201; p <0.001), expectoration (OR = 1.796, 95%CI 1.062–3.036; p 0.029), muscle ache (OR = 0.309, 95%CI 0.153–0.626; p 0.001), and decreased albumin (OR = 1.929, 95%CI 1.199–3.104; p 0.007) as being associated with unimprovement in COVID-19 patients.ConclusionMale sex, a severe COVID-19 condition, expectoration, muscle ache, and decreased albumin were independent risk factors which influence the improvement of COVID-19 patients.