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Factors Predicting Progression to Severe COVID-19: A Competing Risk Survival Analysis of 1753 Patients in Community Isolation in Wuhan, China

Authors :
Simiao Chen
Hui Sun
Mei Heng
Xunliang Tong
Pascal Geldsetzer
Zhuoran Wang
Peixin Wu
Juntao Yang
Yu Hu
Chen Wang
Till Bärnighausen
Source :
Engineering, Vol 13, Iss , Pp 99-106 (2022)
Publication Year :
2022
Publisher :
Elsevier, 2022.

Abstract

Most studies of coronavirus disease 2019 (COVID-19) progression have focused on the transfer of patients within secondary or tertiary care hospitals from regular wards to intensive care units. Little is known about the risk factors predicting the progression to severe COVID-19 among patients in community isolation, who are either asymptomatic or suffer from only mild to moderate symptoms. Using a multivariable competing risk survival analysis, we identify several important predictors of progression to severe COVID-19—rather than to recovery—among patients in the largest community isolation center in Wuhan, China from 6 February 2020 (when the center opened) to 9 March 2020 (when it closed). All patients in community isolation in Wuhan were either asymptomatic or suffered from mild to moderate COVID-19 symptoms. We performed competing risk survival analysis on time-to-event data from a cohort study of all COVID-19 patients (n = 1753) in the isolation center. The potential predictors we investigated were the routine patient data collected upon admission to the isolation center: age, sex, respiratory symptoms, gastrointestinal symptoms, general symptoms, and computed tomography (CT) scan signs. The main outcomes were time to severe COVID-19 or recovery. The factors predicting progression to severe COVID-19 were: male sex (hazard ratio (HR) = 1.29, 95% confidence interval (CI) 1.04–1.58, p = 0.018), young and old age, dyspnea (HR = 1.58, 95% CI 1.24–2.01, p

Details

Language :
English
ISSN :
20958099
Volume :
13
Issue :
99-106
Database :
Directory of Open Access Journals
Journal :
Engineering
Publication Type :
Academic Journal
Accession number :
edsdoj.6520c5fea32b448b8d559d9668babf7d
Document Type :
article
Full Text :
https://doi.org/10.1016/j.eng.2021.07.021