The authors were interested in the characteristics of patients with refractory COVID-19. They conducted a retrospective study in which 155 consecutive patients with confirmed COVID-19 in Zhongnan Hospital, Wuhan were divided into general and refractory COVID-19 groups. Compared with general COVID-19 patients (45.2%), refractory patients were older, male and were more likely to have underlying comorbidities. They also had a lower incidence of fever but higher maximal fevers; higher incidence of shortness of breath and anorexia; worse disease assessments on admission; higher levels of neutrophils, AST, LDH and CRP; lower levels of platelets and albumin; and a higher incidence of bilateral pneumonia and pleural effusion. Refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorants and adjunct therapies, including corticosteroids, antivirals and immune enhancers. Therefore nearly 50% COVID-19 patients did not achieve remission within 10 days of hospitalisation. Patients with male sex, anorexia and no fever on admission predicted poor response to therapy.
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