Risk factors for severe and critically ill COVID‐19 patients: A review

Факторы риска тяжелого и критического течения COVID-19: обзор
Wei Li, Hui Gan, Willem van de Veen, Cezmi A. Akdiş, Mübeccel Akdiş, Can Cao, Ahmet Kürşat Azkur, Dilek Azkur, Milena Sokołowska, Marie‐Charlotte Brüggen, Yadong Gao, Hongyu Gao, Jinjin Zhang, Xiang Dong, Yan Qi, Yiyuan Cao, Mei Ding, Yuanli Sun, Wei Fu, Huiling Liang
2020-11-13

Cytokine stormLymphopeniaRisk factorsSARS-CoV-2Severe COVID-19
The pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an unprecedented global social and economic impact, and high numbers of deaths. Many risk factors have been identified in the progression of COVID-19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type I interferon secretion capacity, and pregnancy. Possible complications include acute kidney injury, coagulation disorders, thoromboembolism. The development of lymphopenia and eosinopenia are laboratory indicators of COVID-19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high-sensitivity C-reactive protein, proinflammatory cytokines such as interleukin (IL)-6, IL-1β, Krebs von den Lungen-6 (KL-6), and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of severity of COVID-19.
1
Acute kidney injury, coagulation disorders, thromboembolism, lymphopenia, and eosinopenia are reported complications or laboratory indicators associated with severe disease.
2
Cytokine storm and extensive abnormalities on chest computed tomography indicate severe disease, while socioeconomic, lifestyle, geographic, treatment-timing, viral-load, and healthcare factors may influence outcomes.
3
Elevated lactate dehydrogenase, procalcitonin, high-sensitivity C-reactive protein, inflammatory cytokines, KL-6, and ferritin may help monitor COVID-19 progression.
4
Immunodeficiency, including impaired early type I interferon secretion, is identified as a potential risk factor for progression to severe COVID-19.
5
Older age, male sex, pregnancy, and comorbidities—including hypertension, diabetes, obesity, cardiopulmonary, liver, kidney, and malignant diseases—are associated with severe or critical COVID-19.

COVID-19 patients and the progression of SARS-CoV-2 infection

Risk factors and clinical, laboratory, imaging, and socioeconomic indicators associated with progression to severe or critical COVID-19

Publication Details
Publication Date
2020-11-13
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1471
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Authors
Wei Li
Hui Gan
Willem van de Veen
Cezmi A. Akdiş
Mübeccel Akdiş
Can Cao
Ahmet Kürşat Azkur
Dilek Azkur
Milena Sokołowska
Marie‐Charlotte Brüggen
Yadong Gao
Hongyu Gao
Jinjin Zhang
Xiang Dong
Yan Qi
Yiyuan Cao
Mei Ding
Yuanli Sun
Wei Fu
Huiling Liang
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