Xu (2020)
Risk factors for adverse clinical outcomes with COVID-19 in China - a multicenter, retrospective, observational study
>=2 comorbidities (Present vs. Not present)
COVID-19 (severe/fatal)
Hazard ratio: 4.778 (2.451-9.315) Adjusted model


Retrospective observational study

Medical records


We systematically analyzed the clinical, laboratory and CT imaging data of laboratory confirmed COVID-19 patients with clear prognostic information in 16 tertiary hospitals from 8 provinces, including 5 of the top 10 provinces - that is, Hubei Province, Zhejiang Province, Anhui Province, Shandong Province, and Jiangsu Province of China between January 10, 2020 and March 13, 2020 and identified the risk factors associated with in-hospital death as well as adverse outcomes.

This study included 703 laboratory-confirmed patients with a mean age of 46.1 years (SD 15.2) (range from 2 months to 86 years old), and 382 (54%) were males, 321 (46%) were females. Of the entire cohort, 648 (92%) discharged without any adverse outcome (stable group), 55 (8%) patients developed adverse clinical outcomes (adverse group), of whom 46 (84%) were admitted to the ICU and 20 (36%) required IMV besides death. The median time (IQR) interval between admission and discharge/adverse outcomes was 16 (11-20) days. At data cutoff, 659 of the total 703 patients (94%) were discharged from the hospital, 33 patients (5%) died, and the remaining 11 patients (2%) were still hospitalized in ICU.


14 Day

COVID-19 (severe/fatal)


composite clinical adverse outcomes including in-hospital death, admission to ICU and requiring IMV.


>=2 comorbidities

>=2 Comorbidies Present vs Comorbidies for discharge and stable groups. Note : Comorbidity (history of cardiovascular disease, diabetes, hypertension, chronic obstructive pulmonary disease [COPD], chronic liver disease, chronic kidney disease, malignancy).

Not present


Hazard ratio

4.778 (2.451-9.315)




Risk adjusted for In-hospital Death and Adverse Outcomes. i) In-hospital Death : >=2 comorbidities, leukocytosis, lymphopenia, CT severity score. ii) Adverse Outcomes : Age, >=2 comorbidities, leukocytosis, lymphopenia, CT severity score.

The primary endpoint was in-hospital death, the secondary endpoints were composite clinical adverse outcomes including in-hospital death, admission to intensive care unit (ICU) and requiring invasive mechanical ventilation support (IMV).