Coronavirus disease 2019 (COVID-19) is a severe acute respiratory illness caused by a novel coronavirus. In March 2020, the World Health Risk factors for severity and death in COVID-19

Published online: April 12, 2020

Organization declared the COVID-19 outbreak a pandemic. 3,346,297 of COVID-19 cases were reported in over a hundred countries worldwide as of May 2, 2020. 238,826 deaths were identified, urging early identification and intervention for severe cases.

In a cohort study recently published in The Journal of Allergy and Clinical Immunology (JACI), Li and colleagues evaluated the severity of 548 patients with COVID-19 on admission and compared the epidemiological, demographic, clinical features, complications, treatment and outcomes between non-severe and severe patients. Potential risk factors for severe COVID-19 morbidity and mortality were analyzed.

The study enrolled 269 severe cases and 279 non-severe cases on admission. The most common symptoms were fever (95.2%), cough (75.5%), dyspnea (56.6%), fatigue (47.1%), chest tightness (38.1%), and diarrhea (32.7%). Six patients were asymptomatic and were diagnosed by CT screening. Severe patients were older and had higher levels of inflammatory markers. Underlying health conditions were more common in severe cases compared with non-severe cases. Interestingly, the prevalence of asthma was unexpectedly low in patients with COVID-19.

The authors reported that elder age, underlying hypertension, high lactate dehydrogenase and high d-dimer levels were associated with severe COVID-19 on admission. During the average 32 days follow-up period, 87 deaths (32.5%) in severe cases were identified. The authors’ findings suggest elderly males with heart injury, hyperglycemia and high-dose corticosteroid use were at a high risk of death.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.