Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China

摘要: Importance Coronavirus disease 2019 (COVID-19) is an emerging infectious that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated. Objective To describe characteristics patients with who developed acute respiratory distress syndrome (ARDS) or died. Design, Setting, Participants Retrospective cohort study 201 confirmed admitted to Wuhan Jinyintan Hospital China between December 25, 2019, January 26, 2020. The final date follow-up February 13, Exposures Confirmed pneumonia. Main Outcomes Measures development ARDS death. Epidemiological, demographic, clinical, laboratory, management, treatment, outcome data were also collected analyzed. Results Of patients, median age 51 years (interquartile range, 43-60 years), 128 (63.7%) men. Eighty-four (41.8%) ARDS, those 84 44 (52.4%) In compared did not, more presented dyspnea (50 [59.5%] 30 117 [25.6%] respectively [difference, 33.9%; 95% CI, 19.7%-48.1%]) had comorbidities such as hypertension (23 [27.4%] 16 [13.7%] 13.7%; 1.3%-26.1%]) diabetes (16 [19.0%] 6 [5.1%] 13.9%; 3.6%-24.2%]). bivariate Cox regression analysis, risk associated progression from death included older (hazard ratio [HR], 3.26; CI 2.08-5.11; HR, 6.17; 3.26-11.67, respectively), neutrophilia (HR, 1.14; 1.09-1.19; 1.08; 1.01-1.17, organ coagulation dysfunction (eg, higher lactate dehydrogenase [HR, 1.61; 1.44-1.79; 1.30; 1.11-1.52, respectively] D-dimer 1.03; 1.01-1.04; 1.02; 1.01-1.04, respectively]). High fever (≥39 °C) likelihood 1.77; 1.11-2.84) lower 0.41; 0.21-0.82). Among treatment methylprednisolone decreased 0.38; 0.20-0.72). Conclusions Relevance Older greater likely owing less rigorous immune response. Although high it better among ARDS. Moreover, may be beneficial develop