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Academic Journal of Medicine & Health Sciences, 2024, 5(2); doi: 10.25236/AJMHS.2024.050205.

Analysis of Risk Factors for Criticalization and Death in Hospitalized Patients with COVID-19 Infection in the Post Epidemic Era

Author(s)

Quan Zeng, Xin Xiaojuan

Corresponding Author:
Xin Xiaojuan
Affiliation(s)

Department of Infection, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

Abstract

To study the risk factors of criticalization and death in hospitalized patients with COVID-19 infection. 320 patients with COVID-19 infection admitted to a tertiary hospital from January to October 2023 were collected, and unifactorial and multifactorial analyses were performed in terms of clinical features, laboratory test results, imaging examinations and treatment measures to find out the risk factors related to the critical deterioration and death of patients hospitalized with new crown among them. The results of multifactorial analysis showed that prolonged hospitalization days, decreased absolute serum lymphocyte values, decreased CD4+ T lymphocytes, increased IL6 counts, and chest CT inflammatory index classification grade IV were risk factors for the evolution of critical illness in patients with COVID-19 infection, whereas comorbid diabetes mellitus, decreased absolute serum lymphocyte values, decreased CD4+ T lymphocytes, and increased IL6 counts were risk factors for death in patients with COVID-19 infection critical illness. The combined test of blood IL-6 and lymphocyte levels and imaging chest CT inflammatory index grading can assess the inflammatory response, immune function, and lung lesion status in patients with COVID-19 infection pneumonia, thus making a prognosis of disease severity and prognosis. Patients with diabetes mellitus, progressive decrease in lymphocyte count, increase in IL-6 level, and grade IV of chest CT inflammation index should be alerted, to achieve early detection, early diagnosis, early intervention, early adjustment of the treatment plan, avoid progressive disease progression, and reduce the rate of criticalization and mortality.

Keywords

COVID-19, hospitalized patients, criticalization, death, risk factors

Cite This Paper

Quan Zeng, Xin Xiaojuan. Analysis of Risk Factors for Criticalization and Death in Hospitalized Patients with COVID-19 Infection in the Post Epidemic Era. Academic Journal of Medicine & Health Sciences (2024), Vol. 5, Issue 2: 30-40. https://doi.org/10.25236/AJMHS.2024.050205.

References

[1] New vaccination plan for coronavirus disease 2019 infection [J]. Chinese Journal of Viral Diseases, 2023, 13(04):241-242.

[2] Dongjing Liu, Deliang Liu, Guiqin Dai. Practice and thinking of COVID-19 epidemic from transformation of infection prevention and control to medical treatment[J]. Chinese Journal of Hygiene Rescue (Electronic Edition), 2023, 09(01): 57-59.

[3] Guidelines on diagnostic and treatment of novel coronavirus pneumonia (Trial 10th edition)[J]. China Medicine, 2023, 36(01):18-25.

[4] Won Hong,Park,Song Soo,Kim,Seung Cheol,Shim,Seung Taek,Song,Sung Soo,Jung,Jin Hwan,Kim, Namkug, Kim,Joon Beom,Seo.Visual Assessment of Chest Computed Tomography Findings in Anti-cyclic Citrullinated Peptide Antibody Positive Rheumatoid Arthritis: Is it Associated with Airway Abnormalities?[J].Lung, 2016, 194(1):97-105.

[5] Committee of the Infectious Diseases Radiology Group of Chinese Society of Radiology, Committee of the Infectious Diseases Radiology Section of Chinese Medical Doctor Association, Infectious Disease Imaging Group, Infectious Disease Branch, Chinese Research Hospital Association, Imaging Committee of Chinese Association for the Prevention and Treatment of STD AIDS Infection (Infectious Disease), Infectious Diseases Group, General Radiological Equipment Committee, China Association of Medical Equipment, Beijing Imaging Diagnosis and Treatment Technology Innovation Alliance. Guideline for imaging diagnosis of novel coronavirus (2019-nCoV) infected pneumonia (1st edition 2020) [J]. New Medicine, 2020,30(1):22-34.

[6] Yi Quan, Tan,Ziting,Wang,Ho Yee,Tiong,Edmund,Chiong.The Good, the Bad, and the Ugly of the COVID-19 Pandemic in a Urology Residency Program in Singapore.[J].Urology,2020,142:244-245.DOI:10.1016/j.urology.2020.05.027.

[7] Jingmei DING, Lei HAN, Lin WANG, Jingbing DU, Fengyu QI. Exploratory Analysis on Outcome Influencing Factors of 200 Patients with COVID-19 [J]. Hospital Administration Journal of Chinese People's Liberation Army, 2020,27(6):511-515.

[8] LIU Chenlu,CHENG Qingrong,TAN Chongbi,Analysis of clinical characteristics of patients with novel coronavirus complicated with respiratory tract bacterial infection in a hospital and evaluation of antiinfection drugs [J]. Journal of Tropical Medicine,2023,23(09):1294-1298.

[9] WANG Jianghong, SUN Yueling, LU Jinguo, FANG Tingting, WU Dan. Significance of peripheral blood lymphocyte dynamics in the diagnosis and treatment of neocoronary pneumonia [J]. Journal of Preventive Medicine of Chinese People's Liberation Army,2020,38(11):115-118. 

[10] JIANG Yi, HU Teng, SI Guo, LIU Bing. Alteration and dynamic observation of T-lymphocyte subsets in novel coronavirus-infected patients[J]. Journal of Practical Hospital Clinics,2020,17(4):35-37.DOI:10.3969/j.issn.1672-6170.2020.04.010.

[11] Cinzia,Auriti,Domenico Umberto,DeRose,Chryssoula,Tzialla,Leonardo, Caforio,Matilde,Ciccia, Paolo, Manzoni,Mauro,Stronati.Vertical Transmission of SARS-CoV-2 (COVID-19): Are Hypotheses More than Evidences?[J].American journal of perinatology,2020,37(S 02):S31-S38.DOI. 10.1055/s-0040-1714346.

[12] Luo Yijun,Wang Yan. Changes in the expression level of interleukin 6 in patients with novel coronavirus pneumonia[J]. Experimental and Laboratory Medicine,2022,40(3):280-281,297.

[13] YAN Yuchen, ZHAO Chao, NIU Chen, YANG Hao, RONG Xingyu, WU Yonglin. Detection and dynamic monitoring of cytokine storm susceptibility factors for the prevention and control of severe and critical novel coronavirus pneumonia[J]. Chinese Journal of Infectious Diseases,2020,38(3):189-192.

[14] YANG Qin,CAO Junhao,DING Jinya et al. Significance of serum calcitoninogen, interleukin 6 and C-reactive protein in the differential diagnosis of sepsis and systemic inflammatory response syndrome[J]. Journal of Clinical Military Medicine,2013,41(07):675-677.

[15] Zhang YK,Jiang B,Yang T et al. Exploration of glucocorticoids in the treatment of generalized neocoronary pneumonia[J]. Chinese Journal of Pulmonary Diseases(Electronic Edition),2020, 13(04): 497-500.

[16] LI XG,XU Yanli,WANG Lin et al. Clinical study of glucocorticoids in the treatment of severe patients with novel coronavirus pneumonia[J]. Journal of Capital Medical University,2020,41(03):345-349.

[17] XING Haiyan,CHEN Jianhong. Effectiveness and safety analysis of glucocorticoids in the treatment of novel coronavirus pneumonia[J]. Chinese Pharmaceutical Industry,2020,29(05):40-43.

[18] CHEN Guangbin, MENG Xianmin, YUAN Jing et al. Suggestions on antiviral medication for novel coronavirus infection in primary care[J]. Shanghai Medicine,2023,44(11):37-43.

[19] Su Liping, Li Xiaoyan, Yang Quan, Wang Xinglan, Ying Jie, Liao Juan, Hu Yong. Clinical application value of CT lung inflammation index grading in novel coronavirus pneumonia[J]. Hainan Medicine, 2020,31(18):2389-2392.

[20] CHANG Haifeng,LIU Juan,WANG Xiaolei,ZHANG Chenwei. Analysis of the first symptoms and chest CT characteristics of acute infection of omikron[J]. Trace Elements and Health Research, 2023, 40(3): 5-6, 8.

[21] Gemma,Llauradó,Bogdan,Vlacho,Matthieu,Wargny,Yue,Ruan,Josep,Franch-Nadal,Pere,Domingo, Pierre, Gourdy,Pierre-Jean,Saulnier,Samy. Hadjadj, Sarah H, Wild, Rustam, Rea, Bertrand, Cariou, Kamlesh, Khunti, Dídac, Mauricio, CORONADO, the ABCD COVID-19 diabetes national audit, HM Hospitales investigators and the Hospital del Mar - Hospital de la Santa Creu i Sant Pau Diabetes Research Group.The association between macrovascular complications and intensive care admission, invasive mechanical ventilation, and mortality in people with diabetes hospitalized for coronavirus disease-2019 (COVID-19). [J].Cardiovascular diabetology, 2022, 21(1):216.

[22] Xie Xiaomin,Bai Guirong,Liu Huili et al.Changes in T lymphoid subpopulations in patients with type 2 diabetes mellitus combined with new coronavirus pneumonia[J]. Ningxia Medical Journal, 2021, 43(03): 264-267.

[23] Shi Xiaopeng, Qin Lijie, Yang Lei, Bai Weimin, Jing Lijuan, Mei Kuikui. Value of interleukin-6 combined with CD4+ T-lymphocyte assay in assessing the severity and prognosis of novel coronavirus pneumonia [J]. Chinese Emergency Medicine for Critical Illness, 2020, 32(10):1165-1170.