Baseline clinical characteristics and prognostic factors in hospitalized COVID-19 patients aged ≤ 65 years: A retrospective observational study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
31
12
2020
accepted:
07
03
2021
entrez:
24
3
2021
pubmed:
25
3
2021
medline:
22
4
2021
Statut:
epublish
Résumé
Individual differences in susceptibility to SARS-CoV-2 infection, symptomatology and clinical manifestation of COVID-19 have thus far been observed but little is known about the prognostic factors of young patients. A retrospective observational study was conducted on 171 patients aged ≤ 65 years hospitalized in Alessandria's Hospital from 1st March to 30th April 2020 with laboratory confirmed COVID-19. Epidemiological data, symptoms at onset, clinical manifestations, Charlson Comorbidity Index, laboratory parameters, radiological findings and complications were considered. Patients were divided into two groups on the basis of COVID-19 severity. Multivariable logistic regression analysis was used to establish factors associated with the development of a moderate or severe disease. A total of 171 patients (89 with mild/moderate disease, 82 with severe/critical disease), of which 61% males and a mean age (± SD) of 53.6 (± 9.7) were included. The multivariable logistic model identified age (50-65 vs 18-49; OR = 3.23 CI95% 1.42-7.37), platelet count (per 100 units of increase OR = 0.61 CI95% 0.42-0.89), c-reactive protein (CPR) (per unit of increase OR = 1.12 CI95% 1.06-1.20) as risk factors for severe or critical disease. The multivariable logistic model showed a good discriminating capacity with a C-index value of 0.76. Patients aged ≥ 50 years with low platelet count and high CRP are more likely to develop severe or critical illness. These findings might contribute to improved clinical management.
Sections du résumé
BACKGROUND
Individual differences in susceptibility to SARS-CoV-2 infection, symptomatology and clinical manifestation of COVID-19 have thus far been observed but little is known about the prognostic factors of young patients.
METHODS
A retrospective observational study was conducted on 171 patients aged ≤ 65 years hospitalized in Alessandria's Hospital from 1st March to 30th April 2020 with laboratory confirmed COVID-19. Epidemiological data, symptoms at onset, clinical manifestations, Charlson Comorbidity Index, laboratory parameters, radiological findings and complications were considered. Patients were divided into two groups on the basis of COVID-19 severity. Multivariable logistic regression analysis was used to establish factors associated with the development of a moderate or severe disease.
FINDINGS
A total of 171 patients (89 with mild/moderate disease, 82 with severe/critical disease), of which 61% males and a mean age (± SD) of 53.6 (± 9.7) were included. The multivariable logistic model identified age (50-65 vs 18-49; OR = 3.23 CI95% 1.42-7.37), platelet count (per 100 units of increase OR = 0.61 CI95% 0.42-0.89), c-reactive protein (CPR) (per unit of increase OR = 1.12 CI95% 1.06-1.20) as risk factors for severe or critical disease. The multivariable logistic model showed a good discriminating capacity with a C-index value of 0.76.
INTERPRETATION
Patients aged ≥ 50 years with low platelet count and high CRP are more likely to develop severe or critical illness. These findings might contribute to improved clinical management.
Identifiants
pubmed: 33760885
doi: 10.1371/journal.pone.0248829
pii: PONE-D-20-41084
pmc: PMC7990225
doi:
Substances chimiques
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0248829Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
JAMA. 2020 Apr 7;323(13):1239-1242
pubmed: 32091533
Clin Chim Acta. 2020 Jul;506:145-148
pubmed: 32178975
J Infect. 2020 Aug;81(2):e16-e25
pubmed: 32335169
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
J Thromb Thrombolysis. 2020 Jul;50(1):211-216
pubmed: 32451823
Clin Chim Acta. 2020 Oct;509:180-194
pubmed: 32511971
PLoS One. 2020 Oct 23;15(10):e0241265
pubmed: 33095835
Biomark Med. 2020 Jun;14(9):713-716
pubmed: 32426991
Pathobiology. 2021;88(1):15-27
pubmed: 33049751
Int J Infect Dis. 2020 Jun;95:304-307
pubmed: 32344011
Clin Infect Dis. 2020 Sep 12;71(6):1393-1399
pubmed: 32271369
J Infect. 2020 Jun;80(6):639-645
pubmed: 32240670
Spinal Cord. 2018 Jul;56(7):625
pubmed: 29977003
Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620937175
pubmed: 32615866
Int J Infect Dis. 2020 Feb;91:264-266
pubmed: 31953166
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Geriatr Gerontol Int. 2020 Jul;20(7):704-708
pubmed: 32516861
Clin Chem Lab Med. 2020 Jun 25;58(7):1021-1028
pubmed: 32286245
Nat Rev Immunol. 2020 Aug;20(8):455-456
pubmed: 32555547
PLoS One. 2020 Dec 15;15(12):e0243600
pubmed: 33320875
J Infect. 2020 Jun;80(6):e14-e18
pubmed: 32171866
J Med Virol. 2021 Mar;93(3):1449-1458
pubmed: 32790106
MMWR Morb Mortal Wkly Rep. 2020 Jun 19;69(24):759-765
pubmed: 32555134
Ann Clin Biochem. 2020 May;57(3):262-265
pubmed: 32266828