Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China.
Identifieur interne : 000041 ( PubMed/Curation ); précédent : 000040; suivant : 000042Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China.
Auteurs : Chaomin Wu [République populaire de Chine] ; Xiaoyan Chen [République populaire de Chine] ; Yanping Cai [République populaire de Chine] ; Jia'An Xia [République populaire de Chine] ; Xing Zhou [République populaire de Chine] ; Sha Xu [République populaire de Chine] ; Hanping Huang [République populaire de Chine] ; Li Zhang [République populaire de Chine] ; Xia Zhou [République populaire de Chine] ; Chunling Du [République populaire de Chine] ; Yuye Zhang [République populaire de Chine] ; Juan Song [République populaire de Chine] ; Sijiao Wang [République populaire de Chine] ; Yencheng Chao [République populaire de Chine] ; Zeyong Yang [République populaire de Chine] ; Jie Xu [République populaire de Chine] ; Xin Zhou [République populaire de Chine] ; Dechang Chen [République populaire de Chine] ; Weining Xiong [République populaire de Chine] ; Lei Xu [République populaire de Chine] ; Feng Zhou [République populaire de Chine] ; Jinjun Jiang [République populaire de Chine] ; Chunxue Bai [République populaire de Chine] ; Junhua Zheng [République populaire de Chine] ; Yuanlin Song [République populaire de Chine]Source :
- JAMA internal medicine [ 2168-6114 ] ; 2020.
Abstract
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated.
DOI: 10.1001/jamainternmed.2020.0994
PubMed: 32167524
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<author><name sortKey="Song, Juan" sort="Song, Juan" uniqKey="Song J" first="Juan" last="Song">Juan Song</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China.</title>
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<author><name sortKey="Zhang, Yuye" sort="Zhang, Yuye" uniqKey="Zhang Y" first="Yuye" last="Zhang">Yuye Zhang</name>
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<author><name sortKey="Song, Juan" sort="Song, Juan" uniqKey="Song J" first="Juan" last="Song">Juan Song</name>
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<author><name sortKey="Wang, Sijiao" sort="Wang, Sijiao" uniqKey="Wang S" first="Sijiao" last="Wang">Sijiao Wang</name>
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<author><name sortKey="Chao, Yencheng" sort="Chao, Yencheng" uniqKey="Chao Y" first="Yencheng" last="Chao">Yencheng Chao</name>
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<author><name sortKey="Yang, Zeyong" sort="Yang, Zeyong" uniqKey="Yang Z" first="Zeyong" last="Yang">Zeyong Yang</name>
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<author><name sortKey="Xu, Jie" sort="Xu, Jie" uniqKey="Xu J" first="Jie" last="Xu">Jie Xu</name>
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<author><name sortKey="Zhou, Xin" sort="Zhou, Xin" uniqKey="Zhou X" first="Xin" last="Zhou">Xin Zhou</name>
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<author><name sortKey="Chen, Dechang" sort="Chen, Dechang" uniqKey="Chen D" first="Dechang" last="Chen">Dechang Chen</name>
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<author><name sortKey="Xiong, Weining" sort="Xiong, Weining" uniqKey="Xiong W" first="Weining" last="Xiong">Weining Xiong</name>
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<author><name sortKey="Xu, Lei" sort="Xu, Lei" uniqKey="Xu L" first="Lei" last="Xu">Lei Xu</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Emergency Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Emergency Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Zhou, Feng" sort="Zhou, Feng" uniqKey="Zhou F" first="Feng" last="Zhou">Feng Zhou</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Jiang, Jinjun" sort="Jiang, Jinjun" uniqKey="Jiang J" first="Jinjun" last="Jiang">Jinjun Jiang</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bai, Chunxue" sort="Bai, Chunxue" uniqKey="Bai C" first="Chunxue" last="Bai">Chunxue Bai</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai</wicri:regionArea>
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</author>
<author><name sortKey="Zheng, Junhua" sort="Zheng, Junhua" uniqKey="Zheng J" first="Junhua" last="Zheng">Junhua Zheng</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai</wicri:regionArea>
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</author>
<author><name sortKey="Song, Yuanlin" sort="Song, Yuanlin" uniqKey="Song Y" first="Yuanlin" last="Song">Yuanlin Song</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai</wicri:regionArea>
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<series><title level="j">JAMA internal medicine</title>
<idno type="eISSN">2168-6114</idno>
<imprint><date when="2020" type="published">2020</date>
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<front><div type="abstract" xml:lang="en">Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated.</div>
</front>
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<DateRevised><Year>2020</Year>
<Month>03</Month>
<Day>13</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2168-6114</ISSN>
<JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year>
<Month>Mar</Month>
<Day>13</Day>
</PubDate>
</JournalIssue>
<Title>JAMA internal medicine</Title>
<ISOAbbreviation>JAMA Intern Med</ISOAbbreviation>
</Journal>
<ArticleTitle>Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China.</ArticleTitle>
<ELocationID EIdType="doi" ValidYN="Y">10.1001/jamainternmed.2020.0994</ELocationID>
<Abstract><AbstractText Label="Importance" NlmCategory="UNASSIGNED">Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated.</AbstractText>
<AbstractText Label="Objective" NlmCategory="UNASSIGNED">To describe the clinical characteristics and outcomes in patients with COVID-19 pneumonia who developed acute respiratory distress syndrome (ARDS) or died.</AbstractText>
<AbstractText Label="Design, Setting, and Participants" NlmCategory="UNASSIGNED">Retrospective cohort study of 201 patients with confirmed COVID-19 pneumonia admitted to Wuhan Jinyintan Hospital in China between December 25, 2019, and January 26, 2020. The final date of follow-up was February 13, 2020.</AbstractText>
<AbstractText Label="Exposures" NlmCategory="UNASSIGNED">Confirmed COVID-19 pneumonia.</AbstractText>
<AbstractText Label="Main Outcomes and Measures" NlmCategory="UNASSIGNED">The development of ARDS and death. Epidemiological, demographic, clinical, laboratory, management, treatment, and outcome data were also collected and analyzed.</AbstractText>
<AbstractText Label="Results" NlmCategory="UNASSIGNED">Of 201 patients, the median age was 51 years (interquartile range, 43-60 years), and 128 (63.7%) patients were men. Eighty-four patients (41.8%) developed ARDS, and of those 84 patients, 44 (52.4%) died. In those who developed ARDS, compared with those who did not, more patients presented with dyspnea (50 of 84 [59.5%] patients and 30 of 117 [25.6%] patients, respectively [difference, 33.9%; 95% CI, 19.7%-48.1%]) and had comorbidities such as hypertension (23 of 84 [27.4%] patients and 16 of 117 [13.7%] patients, respectively [difference, 13.7%; 95% CI, 1.3%-26.1%]) and diabetes (16 of 84 [19.0%] patients and 6 of 117 [5.1%] patients, respectively [difference, 13.9%; 95% CI, 3.6%-24.2%]). In bivariate Cox regression analysis, risk factors associated with the development of ARDS and progression from ARDS to death included older age (hazard ratio [HR], 3.26; 95% CI 2.08-5.11; and HR, 6.17; 95% CI, 3.26-11.67, respectively), neutrophilia (HR, 1.14; 95% CI, 1.09-1.19; and HR, 1.08; 95% CI, 1.01-1.17, respectively), and organ and coagulation dysfunction (eg, higher lactate dehydrogenase [HR, 1.61; 95% CI, 1.44-1.79; and HR, 1.30; 95% CI, 1.11-1.52, respectively] and D-dimer [HR, 1.03; 95% CI, 1.01-1.04; and HR, 1.02; 95% CI, 1.01-1.04, respectively]). High fever (≥39 °C) was associated with higher likelihood of ARDS development (HR, 1.77; 95% CI, 1.11-2.84) and lower likelihood of death (HR, 0.41; 95% CI, 0.21-0.82). Among patients with ARDS, treatment with methylprednisolone decreased the risk of death (HR, 0.38; 95% CI, 0.20-0.72).</AbstractText>
<AbstractText Label="Conclusions and Relevance" NlmCategory="UNASSIGNED">Older age was associated with greater risk of development of ARDS and death likely owing to less rigorous immune response. Although high fever was associated with the development of ARDS, it was also associated with better outcomes among patients with ARDS. Moreover, treatment with methylprednisolone may be beneficial for patients who develop ARDS.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wu</LastName>
<ForeName>Chaomin</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Infection Division, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chen</LastName>
<ForeName>Xiaoyan</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cai</LastName>
<ForeName>Yanping</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Infection Division, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Xia</LastName>
<ForeName>Jia'an</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Tuberculosis and Respiratory Department, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhou</LastName>
<ForeName>Xing</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Infection Division, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Xu</LastName>
<ForeName>Sha</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Infection Division, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Huang</LastName>
<ForeName>Hanping</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Tuberculosis and Respiratory Department, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhang</LastName>
<ForeName>Li</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Tuberculosis and Respiratory Department, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhou</LastName>
<ForeName>Xia</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Tuberculosis and Respiratory Department, Wuhan Jinyintan Hospital, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Du</LastName>
<ForeName>Chunling</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhang</LastName>
<ForeName>Yuye</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Song</LastName>
<ForeName>Juan</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wang</LastName>
<ForeName>Sijiao</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chao</LastName>
<ForeName>Yencheng</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Yang</LastName>
<ForeName>Zeyong</ForeName>
<Initials>Z</Initials>
<AffiliationInfo><Affiliation>Department of Anesthesiology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Xu</LastName>
<ForeName>Jie</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Diseases, Fengxian Guhua Hospital, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhou</LastName>
<ForeName>Xin</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chen</LastName>
<ForeName>Dechang</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Xiong</LastName>
<ForeName>Weining</ForeName>
<Initials>W</Initials>
<AffiliationInfo><Affiliation>Department of Respiratory Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Xu</LastName>
<ForeName>Lei</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Department of Emergency Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhou</LastName>
<ForeName>Feng</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jiang</LastName>
<ForeName>Jinjun</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bai</LastName>
<ForeName>Chunxue</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Shanghai Respiratory Research Institute, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zheng</LastName>
<ForeName>Junhua</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Song</LastName>
<ForeName>Yuanlin</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Shanghai Respiratory Research Institute, Shanghai, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.</Affiliation>
</AffiliationInfo>
</Author>
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<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
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<Month>03</Month>
<Day>13</Day>
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