Risk factors for disease progression in Japanese patients with COVID-19 with no or mild symptoms on admission

• Main Authors: Toshifumi Ninomiya, Kohei Otsubo, Teppei Hoshino, Mototsugu Shimokawa, Megumi Nakazawa, Yoriko Sato, Hironori Mikumo, Satoru Kawakami, Shun Mizusaki, Yusuke Mori, Hidenobu Arimura, Yuko Tsuchiya-Kawano, Koji Inoue, Yujiro Uchida, Yoichi Nakanishi
• Format: Article
• Language: English
• Published: BMC 2021-08-01
• Series: BMC Infectious Diseases
• Subjects: COVID-19; Risk factors; Disease progression
• Online Access: https://doi.org/10.1186/s12879-021-06574-x

Abstract Background Although the risk factors for coronavirus disease 2019 (COVID-19) mortality have been identified, there is limited information about the risk factors for disease progression after hospitalization among Japanese patients with COVID-19 exhibiting no or mild symptoms. Methods All 302 consecutive patients who were admitted to our institutions and diagnosed with COVID-19 between March and December 2020 were retrospectively assessed. Ultimately, 210 adult patients exhibiting no or mild symptoms on admission were included in the analysis. They were categorized into the stable (no oxygen needed) and worsened (oxygen needed) groups, and their characteristics and laboratory data were compared. Results Among 210 patients, 49 progressed to a severe disease stage, whereas 161 did not. The mean patient age was 52.14 years, and 126 (60.0%) patients were male. The mean body mass index (BMI) was 23.0 kg/m2, and 71 patients were overweight (BMI ≥ 25 kg/m2). Multivariate logistic analysis showed that old age, overweight, diabetes mellitus (DM), and high serum ferritin levels were independent risk factors for disease progression. Conclusions Clinicians should closely observe patients with COVID-19, especially those with risk factors such as old age, overweight, DM, and high serum ferritin levels, regardless of whether they have no or mild symptoms.