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Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study

BACKGROUND: To analyze the clinical characteristics and predictors for mortality of adult younger than 60 years old with severe coronavirus disease 2019 (COVID-19). METHODS: We retrospectively retrieved data for 152 severe inpatients with COVID-19 including 60 young patients in the Eastern Campus of...

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Autores principales: Liu, Zilong, Liu, Jie, Ye, Ling, Yu, Kaihuan, Luo, Zhe, Liang, Chao, Cao, Jiangtian, Wu, Xu, Li, Shanqun, Zhu, Lei, Xiang, Guiling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264719/
https://www.ncbi.nlm.nih.gov/pubmed/34277055
http://dx.doi.org/10.21037/jtd-21-120
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author Liu, Zilong
Liu, Jie
Ye, Ling
Yu, Kaihuan
Luo, Zhe
Liang, Chao
Cao, Jiangtian
Wu, Xu
Li, Shanqun
Zhu, Lei
Xiang, Guiling
author_facet Liu, Zilong
Liu, Jie
Ye, Ling
Yu, Kaihuan
Luo, Zhe
Liang, Chao
Cao, Jiangtian
Wu, Xu
Li, Shanqun
Zhu, Lei
Xiang, Guiling
author_sort Liu, Zilong
collection PubMed
description BACKGROUND: To analyze the clinical characteristics and predictors for mortality of adult younger than 60 years old with severe coronavirus disease 2019 (COVID-19). METHODS: We retrospectively retrieved data for 152 severe inpatients with COVID-19 including 60 young patients in the Eastern Campus of Wuhan University affiliated Renmin Hospital in Wuhan, China, from January 31, 2020 to February 20, 2020. We recorded and analyzed patients’ demographic, clinical, laboratory, and chest CT findings, treatment and outcomes data. RESULTS: Of those 60 severe young patients, 15 (25%) were died. Male was more predominant in deceased young patients (12, 80%) than that in recovered young patients (22, 49%). Hypertension was more common among deceased young patients (8, 53%) than that in recovered young patients (7, 16%). Compared with the recovered young patients, more deceased young patients presented with sputum (11, 73%), dyspnea (12, 80%) and fatigue (13, 87%). Only sputum, PSI and neutrophil counts were remained as independent predictors of death in a multivariate logistic regression model. Among ARDS patients, the recovered were administrated with corticosteroid earlier and anticoagulation. The addition of neutrophil counts >6.3×10(9)/L to the SMART-COP score resulted in improved area under the curves. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection in young deceased patients appears to cause exuberant inflammatory responses, leading to compromised oxygen exchange, coagulation and multi-organ dysfunction. In addition, young patients with ARDS could benefit from adjuvant early corticosteroid and anticoagulation therapy. The expanded SMART-COP could predict the fatal outcomes with optimal efficiency.
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spelling pubmed-82647192021-07-16 Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study Liu, Zilong Liu, Jie Ye, Ling Yu, Kaihuan Luo, Zhe Liang, Chao Cao, Jiangtian Wu, Xu Li, Shanqun Zhu, Lei Xiang, Guiling J Thorac Dis Original Article BACKGROUND: To analyze the clinical characteristics and predictors for mortality of adult younger than 60 years old with severe coronavirus disease 2019 (COVID-19). METHODS: We retrospectively retrieved data for 152 severe inpatients with COVID-19 including 60 young patients in the Eastern Campus of Wuhan University affiliated Renmin Hospital in Wuhan, China, from January 31, 2020 to February 20, 2020. We recorded and analyzed patients’ demographic, clinical, laboratory, and chest CT findings, treatment and outcomes data. RESULTS: Of those 60 severe young patients, 15 (25%) were died. Male was more predominant in deceased young patients (12, 80%) than that in recovered young patients (22, 49%). Hypertension was more common among deceased young patients (8, 53%) than that in recovered young patients (7, 16%). Compared with the recovered young patients, more deceased young patients presented with sputum (11, 73%), dyspnea (12, 80%) and fatigue (13, 87%). Only sputum, PSI and neutrophil counts were remained as independent predictors of death in a multivariate logistic regression model. Among ARDS patients, the recovered were administrated with corticosteroid earlier and anticoagulation. The addition of neutrophil counts >6.3×10(9)/L to the SMART-COP score resulted in improved area under the curves. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection in young deceased patients appears to cause exuberant inflammatory responses, leading to compromised oxygen exchange, coagulation and multi-organ dysfunction. In addition, young patients with ARDS could benefit from adjuvant early corticosteroid and anticoagulation therapy. The expanded SMART-COP could predict the fatal outcomes with optimal efficiency. AME Publishing Company 2021-06 /pmc/articles/PMC8264719/ /pubmed/34277055 http://dx.doi.org/10.21037/jtd-21-120 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Liu, Zilong
Liu, Jie
Ye, Ling
Yu, Kaihuan
Luo, Zhe
Liang, Chao
Cao, Jiangtian
Wu, Xu
Li, Shanqun
Zhu, Lei
Xiang, Guiling
Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study
title Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study
title_full Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study
title_fullStr Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study
title_full_unstemmed Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study
title_short Predictors of mortality for hospitalized young adults aged less than 60 years old with severe COVID-19: a retrospective study
title_sort predictors of mortality for hospitalized young adults aged less than 60 years old with severe covid-19: a retrospective study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264719/
https://www.ncbi.nlm.nih.gov/pubmed/34277055
http://dx.doi.org/10.21037/jtd-21-120
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