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 increased COVID-19 severity 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. Treatments 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 (relief of clinical symptoms, clinical outcome, and discharge rate) 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 COVID-19. Arbidol might provide more clinical benefits in treating patients with severe COVID-19 compared with ribavirin.
【저자키워드】 COVID-19, SARS-CoV-2, disease severity, antiviral drug, Associated factors, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, Arbidol, severe COVID-19, Clinical symptoms, fatigue, antiviral drugs, COVID-19 severity, D-dimer, Symptom, hospitalized patients, novel coronavirus disease, risk factor, ribavirin, observational study, Novel coronavirus, Clinical outcome, COVID, Probability, Disease progression, Fever, Dyspnea, Wuhan, female, Patient, severe cases, patients, retrospective, Odds ratio, followed by, Support, Non-invasive, Factor, Logistic regression analysis, ventilator, severe patients, 95% confidence interval, relief, dry cough, clinical benefit, Severe case, Multivariable logistic regression analysis, discharge rate, oxygenation index, antivirus drugs, benefit, invasive, Wuhan, China, Result, identify, performed, was used, collected, evaluate, evaluated, required, hospitalized patient, antivirus drug, with COVID-19, 【제목키워드】 therapy, risk factor, patients with COVID-19,