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dc.creatorZhou, Fei
dc.creatorYu, Ting
dc.creatorDu, Ronghui
dc.creatorFan, Guohui
dc.creatorLiu, Ying
dc.creatorLiu, Zhibo
dc.creatorXiang, Jie
dc.creatorWang, Yeming
dc.creatorSong, Bin
dc.creatorGu, Xiaoying
dc.creatorGuan, Lulu
dc.creatorWei, Yuan
dc.creatorLi, Hui
dc.creatorWu, Xudong
dc.creatorXu, Jiuyang
dc.creatorTu, Shengjin
dc.creatorZhang, Yi
dc.creatorChen, Hua
dc.creatorCao, Bin
dc.date.accessioned2020-09-01T19:33:43Z
dc.date.available2020-09-01T19:33:43Z
dc.date.created2020
dc.identifier.issn0140-6736spa
dc.identifier.otherhttps://doi.org/10.1016/spa
dc.identifier.urihttp://hdl.handle.net/20.500.12010/12565
dc.description.abstractBackground Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratoryconfirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 µg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 µg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.spa
dc.format.extent9 páginasspa
dc.format.mimetypeimage/jepgspa
dc.language.isoengspa
dc.publisherThe Lancetspa
dc.sourcereponame:Expeditio Repositorio Institucional UJTLspa
dc.sourceinstname:Universidad de Bogotá Jorge Tadeo Lozanospa
dc.subjectRisk factorsspa
dc.subjectMortalityspa
dc.subjectCOVID-19spa
dc.titleClinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort studyspa
dc.type.localArtículospa
dc.subject.lembSíndrome respiratorio agudo gravespa
dc.subject.lembCOVID-19spa
dc.subject.lembSARS-CoV-2spa
dc.subject.lembCoronavirusspa
dc.rights.accessrightsinfo:eu-repo/semantics/embargoedAccessspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.rights.localAcceso restringidospa
dc.identifier.doihttps://doi.org/10.1016/spa
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1spa


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