Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan

Excerpt

The recent outbreak of coronavirus disease 2019 (COVID-19), caused by a new zoonotic coronary virus, SARS-CoV-2 [1], is being a great threat to public health. Up to February 11, 2020, it is reported that over 70,000 persons have been infected with SARS-CoV-2 in China [2]. The COVID-19 caused by SARS-CoV-2 infection represents a spectrum of clinical severity [3‐5]. Some patients are asymptomatic or have merely mild upper respiratory tract symptoms. However, SARS-CoV-2 causes pneumonia that can be severe and characterized by fever, cough, dyspnea, bilateral pulmonary infiltrates, and acute respiratory injury. It is estimated that approximately 20% of patients are developing severe respiratory illness, with the overall mortality around 2.3% [2]. Thereby, it is critical to identify individuals who confer intrinsic susceptibility to become severe or even critically ill upon infection, for the purposes of prevention and treatment, especially when there is no drug directly targeting at SARS-CoV-2 that has been proven to be clinically effective. In the study, we explored potential host risk factors associated with severe cases at admission in a retrospective cohort of 487 patients in Zhejiang Province of China and attempt to establish a score system to identify high-risk individuals. We reviewed medical records, laboratory findings, and pulmonary CT scan of each patient with COVID-19, provided by the local health authority and inputted into a pre-specified electronic data collection form. Clinical outcomes were followed up to February 17, 2020. The primary endpoint was occurrence of death and severe cases. …