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. 2021 Feb 13;34(2):419–435. doi: 10.1007/s13577-021-00499-y

Table 3.

Complications, treatments and outcomes of patients with COVID-19

Characteristics All patients Non-severe group Severe group P value Intensive care group Non-intensive care group P value Wuhan residence No Wuhan residence P value
Antiviral drug use
 Lopinavir/ritonavir 160 (93.0) 111 (91.7) 49 (96.0) 0.307 31 (100) 129 (91.5) 0.092 76 (97.4) 84 (89.4) 0.039
 Aerosolized IFN-α1b 166 (96.5) 115 (95.0) 51 (100) 0.106 31 (100) 135 (95.7) 0.242 72 (92.3) 94 (100) 0.006
 Ribavirin 34 (19.8) 22 (18.2) 12 (23.5) 0.421 10 (32.3) 24 (17.0) 0.054 8 (10.3) 26 (27.7) 0.004
 Remdevisir 2 (1.2) 0 (0) 2 (3.9) 0.028 2 (6.5) 0 (0) 0.002 0 (0) 2 (2.1) 0.195
 Darunavir 16 (9.3) 9 (7.4) 7 (13.7) 0.195 4 (12.9) 12 (8.5) 0.446 6 (7.7) 10 (10.6) 0.508
 Arbidol 134 (77.9) 87 (71.9) 47 (92.2) 0.003 29 (93.5) 105 (74.5) 0.020 56 (71.8) 78 (83.0) 0.078
Initial antiviral regime 0.015  < 0.001 0.002
 lopinavir + IFN 30 (17.4) 28 (26.2) 2 (4.9) 0 (0) 30 (21.3) 18 (28.1) 12 (14.3)
 lopinavir + IFN + arbidol 95 (55.2) 61 (57.0) 34 (82.9) 19 (61.3) 76 (53.9) 44 (68.8) 51 (60.7)
 lopinavir + IFN + abidol + ribavirin 16 (9.3) 12 (11.2) 4 (9.8) 4 (12.9) 12 (8.5) 2 (3.1) 14 (16.7)
 Darunavir + IFN + arbidol 7 (4.1) 6 (5.6) 1 (2.4) 5 (16.1) 2 (1.4) 0 (0) 7 (8.3)
 Others 24 (14.0) 14 (11.6) 10 (19.6) 3 (9.7) 21 (14.9) 14 () 10 (10.6)
Any switch of antiviral regimes against SARS-CoV-2 10 (5.8) 2 (1.7) 8 (15.7)  < 0.001 6 (19.4) 4 (2.8)  < 0.001 6 (7.7) 4 (4.3) 0.338
Administration of systemic corticosteroids 98 (57.0) 52 (43.0) 46 (90.2)  < 0.001 29 (93.5) 69 (48.9)  < 0.001 48 (61.5) 50 (53.2) 0.271
Duration of corticosteroid use, days 3.5 ± 4.3 2.1 ± 3.3 6.8 ± 4.7  < 0.001 9.5 ± 5.0 2.2 ± 2.7  < 0.001 3.9 ± 4.5 3.1 ± 4.1 0.363
Administration of intravenous immunoglobulin (IVIG) 67 (39.0) 33 (27.3) 34 (66.7)  < 0.001 25 (80.6) 42 (29.8)  < 0.001 24 (30.8) 43 (45.7) 0.045
Administration of intravenous antibiotics 170 (98.8) 119 (98.4) 51 (100) 0.356 31 (100) 139 (98.6) 0.505 78 (100) 92 (97.9) 0.195
Administration of antifungals 12 (7.0) 1 (0.8) 11 (21.6)  < 0.001 12 (38.7) 0 (0)  < 0.001 8 (10.3) 4 (4.3) 0.124
Administration of Chinese traditional medicine 172 (100) 121 (100) 51 (100) 1.000 31 (100) 141 (100) 1.000 78 (100) 94 (100) 1.000
 Only oral 24 (14.0) 23 (19.0) 1 (2.0) 0.004 0 (0) 24 (17.0) 0.025 9 (11.5) 15 (16.0) 0.067
 Only intravenous 4 (2.3) 4 (3.3) 0 (0) 0 (0) 4 (2.3) 4 (5.1) 0 (0)
 Oral plus intravenous 144 (83.7) 94 (77.7) 50 (98.0) 31 (100) 113 (80.1) 65 (83.3) 79 (84.0)
Main method of respiratory support
 Oxygen therapy on admission 106 (61.6) 63 (52.1) 43 (84.3)  < 0.001 31 (100) 75 (53.2)  < 0.001 42 (53.8) 44 (46.8) 0.358
 High-flow nasal cannula oxygen supply (HFNC) 13 (7.6) 4 (3.3) 9 (17.6)  < 0.001 10 (32.3) 3 (2.1)  < 0.001 8 (10.3) 5 (5.3) 0.223
 Non-invasive ventilation (NIV) 20 (11.6) 1 (0.8) 19 (37.3)  < 0.001 20 (64.5) 0 (0)  < 0.001 9 (11.5) 11 (11.7) 0.973
 Invasive mechanical ventilation (IMV) 12 (7.0) 0 (0) 12 (24.0)  < 0.001 12 (38.7) 0 (0)  < 0.001 8 (10.3) 4 (4.3) 0.516
 All mechanical ventilation (NIV or IMV) 30 (17.4) 2 (1.6) 28 (56.0)  < 0.001 30 (96.8) 0 (0)  < 0.001 14 (17.9) 16 (17.0) 0.858
 Extracorporeal membrane oxygenation (ECMO) 6 (3.5) 0 (0) 6 (12.0) 0.005 6 (19.4) 0 (0)  < 0.001 4 (7.7) 2 (2.1) 0.286
 Length of mechancal ventilation use (days) 0 (0.17.0) 0.15 ± 1.54 2.84 ± 4.53  < 0.001 5.3 ± 5.4 0 (0)  < 0.001 1.2 ± 3.6 2.5 ± 6.2 0.363
Use of continuous renal replacement therapy(CRRT) 6 (3.5) 0 (0) 6 (12)  < 0.001 6 (19.4) 0 (0)  < 0.001 3 (3.8) 3 (3.2) 0.816
Co-infections
 Any 53 (30.8) 29 (24.0) 24 (47.1) 0.003 14 (45.2) 39 (27.7) 0.056 20 (25.6) 33 (35.1) 0.181
 Bacteria 23 (13.4) 12 (9.9) 11 (21.6) 0.040 8 (25.8) 15 (10.6) 0.025 10 (12.8) 13 (13.8) 0.846
 Fungi 9 (5.2) 0 (0) 9 (17.6) <0.001 9 (29.0) 0 (0)  < 0.001 5 (6.3) 4 (4.3) 0.528
 Another virus 10 (5.8) 5 (4.1) 5 (9.8) 0.147 4 (12.9) 6 (4.3) 0.062 4 (5.1) 6 (6.4) 0.726
 M. tuberculosis 1 (0.6) 1 (0.8) 0 (0) 0.515 0 (0) 1 (0.7) 0.638 1 (1.3) 0 (0) 0.271
Length of hospital stay (days) 16.3 ± 5.1 16.1 ± 4.8 16.7 ± 5.8 0.519 15.7 ± 5.6 16.5 ± 5.1 0.529 17.1 ± 5.5 15.8 ± 4.8 0.118
Time from disease onset to first visit 2.9 ± 3.2 3.0 ± 3.4 2.6 ± 2.6 0.482 2.6 ± 2.6 2.9 ± 3.3 0.645 2.7 ± 3.4 2.9 ± 3.2 0.681
Time from confirmation to initial antiviral treatment 0.5 ± 1.1 0.5 ± 1.2 0.5 ± 1.0 0.728 0.6 ± 1.3 0.5 ± 1.1 0.493 0.7 ± 1.3 0.4 ± 1.0 0.119
Time to the first negative nasopharygeal swab nucleic acid test (days) 13.1 ± 5.0 13.1 ± 4.9 13.3 ± 5.5 0.798 13.4 ± 6.0 13.2 ± 4.8 0.822 13.5 ± 5.4 13.0 ± 4.7 0.589
Time of onset to confirmation 6.1 ± 3.7 6.0 ± 3.9 6.1 ± 3.1 0.866 5.7 ± 2.9 6.1 ± 3.8 0.555 5.6 ± 3.6 6.5 ± 3.7 0.123
Time to afebrile, days 6.6 ± 6.1 5.7 ± 5.3 8.6 ± 7.1 0.004 11.1 ± 7.6 5.5 ± 5.2  < 0.001 6.9 ± 7.0 6.3 ± 5.2 0.496
CURB-65 score 0 (0,2) 0.1 ± 0.4 0.5 ± 0.6  < 0.001 0.6 ± 0.7 0.1 ± 0.4  < 0.001 0.1 ± 0.3 0.3 ± 0.6 0.008
 0 136 (79.1) 106 (87.6) 30 (58.8) 14 (45.2) 122 (86.5)  < 0.001 68 (87.2) 68 (72.3) 0.029
 1 32 (18.6) 14 (11.6) 18 (35.3) 14 (45.2) 18 (12.8) 10 (12.8) 22 (23.4)
 2 4 (2.3) 1 (0.8) 3 (5.9) 3 (9.7) 1 (0.7) 0 (0) 4 (4.3)
  ≥ 3 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
PSI score 46.5 ± 22.1 40.6 ± 20.7 60.5 ± 18.6  < 0.001 61.4 ± 20.0 43.2 ± 21.2  < 0.001 45.7 ± 18.8 47.1 ± 24.5 0.675
 PSI grade I and II (score ≤ 70) 150 (87.2) 111 (91.7) 39 (76.5) 0.012 22 (71.0) 128 (90.8) 0.011 72 (92.3) 78 (83.0) 0.189
 PSI grade III (70 < score ≤ 90) 16 (9.3) 8 (6.6) 7 (13.7) 6 (19.4) 9 (6.4) 4 (5.1) 11 (11.7)
 PSI grade IV (90 < score ≤ 130) 6 (3.5) 2 (1.7) 5 (9.8) 3 (9.7) 4 (2.8) 2 (2.6) 5 (5.3)
 PSI grade IV (score > 130) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
MuLBSTA score 7.0 ± 4.3 5.8 ± 4.1 9.8 ± 3.4  < 0.001 10.5 ± 3.2 6.2 ± 4.2  < 0.001 6.8 ± 4.0 7.1 ± 4.6 0.645
 MuLBSTA score > 12 26 (15.1) 11 (9.1) 15 (29.4) 0.001 13 (41.9) 13 (9.2)  < 0.001 8 (10.3) 18 (19.1) 0.105
Deterioration at 72 h of admission 40 (23.3) 19 (15.7) 21 (41.2)  < 0.001 20 (64.5) 20 (14.2)  < 0.001 21 (26.9) 19 (20.2) 0.300
Lymphocyte count on 72 h of admission, × 109/L 1.26 ± 0.54 1.40 ± 0.53 0.95 ± 0.39  < 0.001 0.97 ± 0.48 1.29 ± 0.53 0.002 1.16 ± 0.52 1.30 ± 0.54 0.081
Decrease of lymphocyte count on 48-96 h of admission 59 (34.3) 39 (32.2) 20 (40) 0.378 10 (32.3) 49 (34.8) 0.791 26 (33.3) 33 (35.1) 0.807
Lymphopenia 48-96 h after admission 118 (68.6) 72 (59.5) 46 (90.2)  < 0.001 23 (74.2) 95 (67.4) 0.459 56 (71.8) 62 (66.0) 0.412
ICU stay 88 (51.2) 43 (35.5) 45 (88.2)  < 0.001 29 (93.5) 59 (41.8)  < 0.001 40 (51.3) 48 (51.1) 0.977
Use of IMV, ECMO or death 15 (8.7) 2 (1.7) 13 (25.5)  < 0.001 15 (48.4) 0 (0)  < 0.001 10 (12.8) 5 (5.3) 0.083
Complications
 Shock (of any cause) 6 (3.5) 0 (0) 6 (12.0) 0.005 6 (19.4) 0 (0)  < 0.001 4 (5.1) 2 (2.1) 0.273
 Liver injury 20 (11.6) 11 (9.1) 9 (17.6) 0.110 9 (29.0) 11 (7.8) 0.001 10 (12.8) 10 (10.6) 0.657
 Myocardial injury 15 (8.7) 4 (3.3) 11 (21.6)  < 0.001 13 (41.9) 2 (1.4)  < 0.001 12 (15.4) 3 (3.2) 0.005
 Acute kidney injury 10 (5.8) 2 (1.6) 8 (16.0) 0.006 8 (25.8) 2 (1.4)  < 0.001 4 (5.1) 6 (6.4) 0.726
 Pneumonthorax 3 (1.7) 0 (0) 3 (5.9) 0.007 3 (9.7) 0 (0)  < 0.001 1 (1.3) 2 (2.1) 0.673
 Major bleeding§ 3 (1.7) 1 (0.8) 2 (3.9) 0.157 3 (9.7) 0 (0) 0.003 1 (1.3) 2 (2.1) 0.673
Outcomes
 Discharge 160 (93.0) 116 (95.9) 44 (86.3) 0.001 26 (83.9) 134 (95.0) 0.001 72 (92.3) 88 (93.6) 0.945
 Death 4 (2.3) 0 (0) 4 (7.8) 4 (12.9) 0 2 (2.6) 2 (2.1)
 On treatment 8 (4.7) 5 (4.1) 3 (5.9) 1 (3.2) 7 (5.0) 4 (5.1) 4 (4.3)

*Stable means no fever, no complications and other clinical situations that required treatment modifications, no radiological deterioration

#Includes

§Major bleeding refers to bleeding that inquiring immediate treatment, including therapy modifications or transfusion

Judging by an expert panel basing on the clinco-radiological status on reevaluation