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Abstract

Background

In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization.

Aim

Our objective was to identify risk factors predictive of severe disease and death in France.

Methods

In this prospective cohort study, we included patients ≥ 18 years old with confirmed COVID-19, hospitalised in Strasbourg and Mulhouse hospitals (France), in March 2020. We respectively compared patients who developed severe disease (admission to an intensive care unit (ICU) or death) and patients who died, to those who did not, by day 7 after hospitalisation.

Results

Among 1,045 patients, 424 (41%) had severe disease, including 335 (32%) who were admitted to ICU, and 115 (11%) who died. Mean age was 66 years (range: 20–100), and 612 (59%) were men. Almost 75% of patients with body mass index (BMI) data (n = 897) had a BMI ≥ 25 kg/m2 (n = 661). Independent risk factors associated with severe disease were advanced age (odds ratio (OR): 1.1 per 10-year increase; 95% CrI (credible interval): 1.0–1.2), male sex (OR: 2.1; 95% CrI: 1.5–2.8), BMI of 25–29.9 kg/m2 (OR: 1.8; 95% CrI: 1.2–2.7) or ≥ 30 (OR: 2.2; 95% CrI: 1.5–3.3), dyspnoea (OR: 2.5; 95% CrI: 1.8–3.4) and inflammatory parameters (elevated C-reactive protein and neutrophil count, low lymphocyte count). Risk factors associated with death were advanced age (OR: 2.7 per 10-year increase; 95% CrI: 2.1–3.4), male sex (OR: 1.7; 95% CrI: 1.1–2.7), immunosuppression (OR: 3.8; 95% CrI: 1.6–7.7), diabetes (OR: 1.7; 95% CrI: 1.0–2.7), chronic kidney disease (OR: 2.3; 95% CrI: 1.3–3.9), dyspnoea (OR: 2.1; 95% CrI: 1.2–3.4) and inflammatory parameters.

Conclusions

Overweightedness, obesity, advanced age, male sex, comorbidities, dyspnoea and inflammation are risk factors for severe COVID-19 or death in hospitalised patients. Identifying these features among patients in routine clinical practice might improve COVID-19 management.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2020-12-03
2024-12-21
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Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Charlotte+Kaeuffer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kaeuffer Charlotte</a>, <a href="/search?value1=Coralie+Le+Hyaric&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Le Hyaric Coralie</a>, <a href="/search?value1=Thibaut+Fabacher&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fabacher Thibaut</a>, <a href="/search?value1=Joy+Mootien&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mootien Joy</a>, <a href="/search?value1=Benjamin+Dervieux&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dervieux Benjamin</a>, <a href="/search?value1=Yvon+Ruch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ruch Yvon</a>, <a href="/search?value1=Antonin+Hugerot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hugerot Antonin</a>, <a href="/search?value1=Yves-Jean+Zhu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zhu Yves-Jean</a>, <a href="/search?value1=Valentin+Pointurier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pointurier Valentin</a>, <a href="/search?value1=Raphael+Clere-Jehl&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Clere-Jehl Raphael</a>, <a href="/search?value1=Valentin+Greigert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Greigert Valentin</a>, <a href="/search?value1=Loic+Kassegne&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kassegne Loic</a>, <a href="/search?value1=Nicolas+Lefebvre&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lefebvre Nicolas</a>, <a href="/search?value1=Floriane+Gallais&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gallais Floriane</a>, <a href="/search?value1=Covid+Alsace+Study+Group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Covid Alsace Study Group</a>, <a href="/search?value1=Nicolas+Meyer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meyer Nicolas</a>, <a href="/search?value1=Yves+Hansmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hansmann Yves</a>, <a href="/search?value1=Olivier+Hinschberger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hinschberger Olivier</a>, <a href="/search?value1=Fran%C3%A7ois+Danion&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Danion François</a></span>. Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020. <a href="/content/ecdc">Euro Surveill.</a> 2020;25(48):pii=2000895. <a href="https://doi.org/10.2807/1560-7917.ES.2020.25.48.2000895" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2020.25.48.2000895</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 11 May 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 14 Aug 2020 </span> </p>
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