{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:15:16Z","timestamp":1769202916146,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T00:00:00Z","timestamp":1650672000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Advances in Virology"],"published-print":{"date-parts":[[2022,4,23]]},"abstract":"<jats:p>Purpose. Septic shock is a severe complication of COVID-19 patients. We aim to identify risk factors associated with septic shock and mortality among COVID-19 patients. Methods. A total of 212 COVID-19 confirmed patients in Wuhan were included in this retrospective study. Clinical outcomes were designated as nonseptic shock and septic shock. Log-rank test was conducted to determine any association with clinical progression. A prediction model was established using random forest. Results. The mortality of septic shock and nonshock patients with COVID-19 was 96.7% (29\/30) and 3.8% (7\/182). Patients taking hypnotics had a much lower chance to develop septic shock (HR\u2009=\u20090.096, <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.0014<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). By univariate logistic regression analysis, 40 risk factors were significantly associated with septic shock. Based on multiple regression analysis, eight risk factors were shown to be independent risk factors and these factors were then selected to build a model to predict septic shock with AUC\u2009=\u20090.956. These eight factors included disease severity (HR\u2009=\u200915, <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.001<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), age\u2009&gt;\u200965 years (HR\u2009=\u20092.6, <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.012<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>), temperature\u2009&gt;\u200939.1\u00b0C (HR\u2009=\u20092.9, <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.047<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), white blood cell count &gt; 10\u2009\u00d7\u200910\u2079 (HR\u2009=\u20096.9, <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>&lt;<\/i:mo>\n                        <i:mn>0.001<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>), neutrophil count &gt; 75\u2009\u00d7\u200910\u2079 (HR\u2009=\u20092.4, <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>p<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.022<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>), creatine kinase &gt; 5\u2009U\/L (HR\u2009=\u20091.8, <jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>p<\/m:mi>\n                        <m:mo>=<\/m:mo>\n                        <m:mn>0.042<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>), glucose &gt; 6.1\u2009mmol\/L (HR\u2009=\u20097, <jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mi>p<\/o:mi>\n                        <o:mo>&lt;<\/o:mo>\n                        <o:mn>0.001<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>), and lactate &gt; 2\u2009mmol\/L (HR\u2009=\u200922, <jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mi>p<\/q:mi>\n                        <q:mo>&lt;<\/q:mo>\n                        <q:mn>0.001<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>). Conclusions. We found 40 risk factors were significantly associated with septic shock. The model contained eight independent factors that can accurately predict septic shock. The administration of hypnotics could potentially reduce the incidence of septic shock in COVID-19 patients.<\/jats:p>","DOI":"10.1155\/2022\/3178283","type":"journal-article","created":{"date-parts":[[2022,4,24]],"date-time":"2022-04-24T04:35:05Z","timestamp":1650774905000},"page":"1-9","source":"Crossref","is-referenced-by-count":11,"title":["Association of Septic Shock with Mortality in Hospitalized COVID-19 Patients in Wuhan, China"],"prefix":"10.1155","volume":"2022","author":[{"given":"Shaoqiu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA"},{"name":"Molecular Biosciences and Bioengineering Program, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zitong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA"},{"name":"Molecular Biosciences and Bioengineering Program, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Hu","sequence":"additional","affiliation":[{"name":"Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-2429","authenticated-orcid":true,"given":"Yi","family":"Zuo","sequence":"additional","affiliation":[{"name":"Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meilin","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Jiangxi 330006, Nanchang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emory","family":"Zitello","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA"},{"name":"Molecular Biosciences and Bioengineering Program, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3936-9123","authenticated-orcid":true,"given":"Gang","family":"Huang","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5951-8213","authenticated-orcid":true,"given":"Youping","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, John A. 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