Li (2020)
Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan
Patient characteristics
Gender (Male vs. Female)
COVID-19 (death)
Hazard ratio: 1.720 (1.050-2.820) Adjusted model


Ambispective cohort study

Medical records


Patients with severe COVID-19 admitted to Tongji Hospital from January 26, 2020 to February 5, 2020 were retrospectively enrolled and followed-up until March 3, 2020.

A total of 549 patients with COVID-19 were enrolled, of whom 548 cases were included in the study. One case not meeting inclusion criteria was excluded due to inclusion criteria. Almost half of the patients (49.1%, 269 of 548) were identified as severe cases and 50.9% (279 of 548) were nonsevere cases on admission. 68.7% (347 of 505) of cases were positive for SARS-CoV-2 nucleic acid test pre-admission. Elder age, underlying hypertension, high cytokine levels (IL-2R, IL-6, IL-10, and TNF-a), and high LDH level were significantly associated with severe COVID-19 on admission. High-dose corticosteroid use was related to high risk of death. The levels of procalcitonin, globulin, lactate dehydrogenase (LDH), NT-proB-type natriuretic peptide (NT-proBNP), d-dimer, alanine aminotransferase, aspartate aminotransferase, total bilirubin, conjugated bilirubin, blood urea nitrogen, and creatinine were elevated in 9.5%, 40.4%, 73.6%, 27.5%, 67.4%, 23.1%, 33.1%, 4.4%, 9.2%, 15.8%, and 27.1% of all patients, respectively. Serum cytokine levels of IL-2R, IL-6, IL-10, and TNF-? were significantly higher in severe patients than those in nonsevere patients.


32 Day

COVID-19 (death)


Death due to COVID-19

Patient characteristics





Hazard ratio

1.720 (1.050-2.820)




The final model was adjusted for sex, age, blood leukocyte count, lactose dehydrogenase, cardiac injury, hyperglycemia, and administration of corticosteroids, lopinavir/ritonavir, and umifenovir.

Patients with elder age, hypertension, and high LDH level need careful observation and early intervention to prevent the potential development of severe COVID-19. Severe male patients with heart injury, hyperglycemia, and high-dose corticosteroid use may have high risk of death.