A retrospective study of risk factors for severe acute respiratory syndrome coronavirus 2 infections in hospitalized adult patients

INTRODUCTION Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection spread worldwide. OBJECTIVES The aim of the study was to identify the clinical characteristics and risk factors associated with severe incidence of SARS-CoV-2 infection. PATIENTS AND METHODS All adult patients (median [IQR] age, 52 [37-58] years) consecutively admitted to the Dabieshan Medical Center from January 30, 2020 to February 11, 2020 were collected and reviewed. Only patients diagnosed with COVID-19 according to the World Health Organization interim guidance were included in this retrospective cohort study. RESULTS A total of 108 patients with COVID-19 were retrospectively analyzed. Twenty-five patients (23.1%) developed severe disease, and of those 12 patients (48%) died. Advanced age, comorbidities (most commonly hypertension), higher blood leukocyte count, neutrophil count, higher C-reactive protein level, D-dimer level, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score were associated with greater risk of COVID-19, and so were lower lymphocyte count and albumin level. Multivariable regression showed increasing odds of severe COVID-19 associated with higher SOFA score (odds ratio [OR], 2.45; 95% CI, 1.302-4.608; P = 0.005), and lymphocyte count less than 0.8 x 10(9)/l (OR, 9.017; 95% CI, 2.808-28.857; P <0.001) on admission. Higher SOFA score (OR, 2.402; 95% CI, 1.313- 4.395; P = 0.004) on admission was identified as risk factor for in-hospital death. CONCLUSIONS Lymphocytopenia and a higher SOFA score on admission could help clinicians to identify patients at high risk for developing severe COVID-19. More related studies are needed in the future.