Factors significantly associated with COVID-19 severity in symptomatic patients: A retrospective single-center study.

Abstract

INTRODUCTION:

The severity of coronavirus disease (COVID-19) in Japanese patients is unreported. We retrospectively examined significant factors associated with disease severity in symptomatic COVID-19 patients (COVID-Pts) admitted to our institution between February 20 and April 30, 2020.

METHODS:

All patients were diagnosed based on the genetic detection of severe acute respiratory syndrome coronavirus 2. Information on the initial symptoms, laboratory data, and computed tomography (CT) images at hospitalization were collected from the patients' records. COVID-Pts were categorized as those with critical or severe illness (Pts-CSI) or those with moderate or mild illness (Pt-MMI). All statistical analyses were performed using R software.

RESULTS:

Data from 61 patients (16 Pt-CSI, 45 Pt-MMI), including 58 Japanese and three East Asians, were analyzed. Pt-CSI were significantly older and had hypertension or diabetes than Pt-MMI (P < 0.001, 0.014 and < 0.001, respectively). Serum albumin levels were significantly lower in Pt-CSI than in Pt-MMI (P < 0.001), whereas the neutrophil-to-lymphocyte ratio and C-reactive protein level were significantly higher in Pt-CSI than in Pt-MMI (P < 0.001 and P < 0.001, respectively). In the CT images of 60 patients, bilateral lung lesions were more frequently observed in Pt-CSI than in Pt-MMI (P = 0.013). Among the 16 Pt-CSI, 15 received antiviral therapy, 12 received tocilizumab, five underwent methylprednisolone treatment, six received mechanical ventilation, and one died.

CONCLUSIONS:

The illness severity of Japanese COVID-Pts was associated with older age, hypertension and/or diabetes, low serum albumin, high neutrophil-to-lymphocyte ratio, and C-reactive protein.

• Authors: Tomonori Hirashima, Tsuyoshi Arai, Heita Kitajima, Yoshitaka Tamura, Tomoki Yamada, Shoji Hashimoto, Hiroshi Morishita, Seijiro Minamoto, Kayoko Kawashima, Yozo Kashiwa, Makoto Kameda, Tohru Takeshita, Hidekazu Suzuki, Hiroto Matsuoka, Seiji Yamaguchi, Toshio Tanaka, Takayuki Nagai
• Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 27 Issue 1 Pg. 76-82 (Jan 2021) ISSN: 1437-7780 [Electronic] Netherlands
• PMID: 33051144 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Antibodies, Monoclonal, Humanized
• Antiviral Agents
• Serum Albumin
• C-Reactive Protein
• tocilizumab
• Methylprednisolone

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antiviral Agents (therapeutic use)
• Betacoronavirus
• C-Reactive Protein (analysis)
• COVID-19
• Coronavirus Infections (epidemiology, therapy)
• Female
• Humans
• Japan (epidemiology)
• Lung (diagnostic imaging, pathology)
• Male
• Methylprednisolone (therapeutic use)
• Middle Aged
• Neutrophils
• Pandemics
• Pneumonia, Viral (epidemiology, therapy)
• Respiration, Artificial
• Retrospective Studies
• Risk Factors
• SARS-CoV-2
• Serum Albumin (analysis)
• Severity of Illness Index
• Tomography, X-Ray Computed
• Young Adult