Published time: 09 April 2020
Authors: Bahaa Abu-Raya
Keywords: Coronavirus, SARS-COV-2, COVID-19
The pandemic of Coronavirus disease (COVID-19) is rapidly spreading and clinicians across the globe are facing it with limited scientific evidence to support their management. There is a critical lack of predictive factors that can guide clinicians in identifying patients at risk for prolonged, and thus potentially more severe, COVID-19 that needs early and aggressive therapeutic approach. This fact has urged Mo and colleagues to retrospectively characterize patients with refractory COVID-19 as compared with patients with non-refractory COVID-19 (termed “general COVID-19”) . The authors reported that patients classified as refractory COVID-19 were more likely to be older, of male sex, have underlying comorbidities, be afebrile, have shortness of breath and anorexia, and to have laboratory abnormalities and radiological changes. In addition, refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorant, adjunctive treatment including corticosteroids, antiviral drugs and immune enhancers when compared to general COVID-19 patients. The authors have further attempted to explore predictive factors for refractory COVID-19 using a multivariate analysis showing that male sex, anorexia on admission and being afebrile are independent risk factors for the development of a refractory disease. Furthermore, out of this analysis the authors have found that patients with refractory COVID-19 were more likely to receive oxygen, expectorant, corticosteroids, lopinavir/ritonavir and immune enhancer.
Predictors of refractory Coronavirus disease (COVID-19) pneumonia