Abstract
The factors predicting the progression of coronavirus disease-2019 (COVID-19) from mild to moderate to critical are unclear. We retrospectively evaluated risk factors for disease progression in Japanese patients with COVID-19. Seventy-four patients with laboratory-confirmed COVID-19 were hospitalized in our hospital between February 20, 2020, and June 10, 2020. We excluded asymptomatic, non-Japanese, and pediatric patients. We divided patients into the stable group and the progression group (PG; requiring mechanical ventilation). We compared the clinical factors. We established the cutoff values (COVs) for significantly different factors via receiver operating characteristic curve analysis and identified risk factors by univariate regression. We enrolled 57 patients with COVID-19 (median age 52 years, 56.1% male). The median time from symptom onset to admission was 8 days. Seven patients developed critical disease (PG: 12.2%), two (3.5%) of whom died; 50 had stable disease. Univariate logistic analysis identified an elevated lactate dehydrogenase (LDH) level (COV: 309 U/l), a decreased estimated glomerular filtration rate (eGFR; COV: 68 ml/min), lymphocytopenia (COV: 980/μl), and statin use as significantly associated with disease progression. However, in the Cox proportional hazards analysis, lymphocytopenia at admission was not significant. We identified three candidate risk factors for progression to critical COVID-19 in adult Japanese patients: statin use, elevated LDH level, and decreased eGFR.
Keywords: COVID-19; Japanese patients; comorbidity; critical disease; disease progression; laboratory finding; risk factors.
【저자키워드】 COVID-19, Risk factors, Comorbidity, Disease progression, Critical disease, Japanese patients, laboratory finding, 【초록키워드】 coronavirus disease, coronavirus, Risk factors, Hospitalized, mechanical ventilation, hospital, LDH, Comorbidity, progression, risk factor, lactate dehydrogenase, Laboratory, coronavirus disease-2019, Disease progression, Asymptomatic, Pediatric patients, lymphocytopenia, male, Patient, statin, Mild, EGFR, Japanese, characteristic, disease, Admission, Critical, moderate, Critical disease, glomerular filtration rate, laboratory finding, Lactate, Analysis, mild to moderate, receiver operating characteristic, filtration rate, symptom onset, Logistic, Factor, not significant, Laboratory-confirmed COVID-19, median time, median age, CoVs, clinical factors, cutoff value, laboratory-confirmed, elevated lactate dehydrogenase, Cox proportional hazards analysis, enrolled, significantly, evaluated, elevated, excluded, Cox proportional hazard, patients with COVID-19, 【제목키워드】 Patient, Japanese, retrospective, single-center, clinical factor,