The characteristics and outcomes of 681 severe cases with COVID-19 in China release_rev_f8f7b3dd-3aab-42d4-9cae-aa5335aedb6f

by Fang-fang Chen, Ming Zhong, Ya Liu, Yi Zhang, Kai Zhang, De-zhen Su, Xiao Meng, Yun Zhang

Published in Journal of critical care by Elsevier BV.

2020   Volume 60, p32-37

Abstract

To clarify the epidemiological, clinical, and therapeutic features of patients with severe COVID-19. In this study, we enrolled 681 patients with confirmed cases of severe COVID-19. The epidemiological, demographic, clinical, laboratory, treatment, and outcome data were collected. The median age of the study participants was 65 years, 53.2% were male, and 104 (15.3%) died. Age, Neutrophil-To-Lymphocyte Ratio (NLR), acute myocardial injury, and levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), and CD3 T cells counts were independently associated with death, while arbidol and ribavirin were protective from death. The combination of NLR and acute myocardial injury on admission (AUC = 0.914) predicted mortality better than NLR, CRP, LDH, and acute myocardial injury. There were 312 (45.8%) patients with cardiovascular disease, of whom 23.4% died. β-blockers, ACEI/ARB, arbidol, and ribavirin might have a beneficial effect for severe COVID-19 patients with cardiovascular disease. The combination of NLR and acute myocardial injury on admission was highly predictive of mortality and survival. Clinicians should adopt more aggressive strategies for patients with a high NLR (>6.66) combined with myocardial injury. β-blockers and ACEI/ARB, as well as arbidol and ribavirin, were effective in COVID-19 patients with cardiovascular disease.
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Type  article-journal
Stage   published
Date   2020-07-08
Language   en ?
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ISSN-L:  0883-9441
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