Risk factors for the COVID-19 severity and its correlation with viral shedding: A retrospective cohort study

J Med Virol. 2021 Feb;93(2):952-961. doi: 10.1002/jmv.26367. Epub 2020 Sep 16.

Abstract

Coronavirus disease 2019 (COVID-19) have become a pandemic in the world. This study is aim to explore risk factors for COVID-19 severity in the early stage and the correlation between the viral shedding and COVID-19 severity. We included inpatient with laboratory confirmed COVID-19 who had been discharged by 9 March 2020. The medical record data and dynamic change of biochemical indicators in-hospital were compared between common and severe patients. Eighty patients were included in this study. Multivariable regression demonstrated increasing odds of severity associated with the duration of fever (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.10-1.82, per day increase; P = .007), C-reactive protein (CRP) (OR, 1.26; 95% CI, 1.04-1.52; P = .02), and PO2 < 80 mm Hg (28.07, 95% CI, 1.50-524.12; P = .026) on admission. We found severe acute respiratory syndrome coronavirus 2 viral RNA could be long-term presence in respiratory tract and fecal sample, up to 43 and 46 days, respectively. However, the duration of viral shedding have no correlation with the COVID-19 severity. The duration of fever, elevated CRP and PO2 < 80 mm Hg on admission were associated with the COVID-19 severity in the early stage and there is no correlation between the viral shedding and COVID-19 severity.

Keywords: COVID-19; retrospective cohort study; risk factors; severity; viral shedding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / analysis
  • COVID-19 / physiopathology*
  • COVID-19 / virology*
  • Feces / virology
  • Female
  • Fever / virology
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Medical Records
  • Middle Aged
  • Odds Ratio
  • Respiratory System / virology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / pathogenicity*
  • SARS-CoV-2 / physiology
  • Severity of Illness Index
  • Virus Shedding*
  • Young Adult

Substances

  • C-Reactive Protein