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This study aimed to identify the factors associated with increased COVID-19 severity and evaluate the current antiviral drugs, especially in severe patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a retrospective observational study performed at the No. 7 Hospital of Wuhan (Wuhan, China) with hospitalized patients confirmed with COVID-19 from January 11 to March 13, 2020. Multivariable logistic regression analysis was used to identify the associated factors of severe COVID. Treatments of antivirus drugs were collected and evaluated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 550 patients, 292 (53.1%) were female and 277 (50.4%) were\u00a0<jats:underline>&gt;<\/jats:underline>\u00a060\u2009years old. The most common symptom was fever (<jats:italic>n<\/jats:italic>\u2009=\u2009372, 67.7%), followed by dry cough (<jats:italic>n<\/jats:italic>\u2009=\u2009257, 46.7%), and dyspnea (<jats:italic>n<\/jats:italic>\u2009=\u2009237, 43.1%), and fatigue (<jats:italic>n<\/jats:italic>\u2009=\u2009224, 40.7%). Among the severe patients, 20.2% required invasive ventilator support and 18.0% required non-invasive ventilator. The identified risk factors for severe cases were: age\u2009\u2265\u200960\u2009years (odds ratio (OR) =3.02, 95% confidence interval (CI): 1.13\u20138.08, <jats:italic>P<\/jats:italic>\u2009=\u20090.028), D-dimer &gt;\u20090.243\u2009\u03bcg\/ml (OR\u2009=\u20092.734, 95%CI: 1.012\u20137.387, <jats:italic>P<\/jats:italic>\u2009=\u20090.047), and low oxygenation index (OR\u2009=\u20090.984, 95%CI: 0.980\u20130.989, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In severe cases, the benefits (relief of clinical symptoms, clinical outcome, and discharge rate) of arbidol alone was 73.3%, which was better than ribavirin (7\/17, 41.2%, <jats:italic>P<\/jats:italic>\u2009=\u20090.029).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Age\u00a0<jats:underline>&gt;<\/jats:underline>\u00a060\u2009years, D-dimer &gt;\u20090.243\u2009\u03bcg\/ml, and lower oxygenation index were associated with severe COVID-19. Arbidol might provide more clinical benefits in treating patients with severe COVID-19 compared with ribavirin.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06282-6","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T11:08:58Z","timestamp":1623323338000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Associated risk factors with disease severity and antiviral drug therapy in patients with COVID-19"],"prefix":"10.1186","volume":"21","author":[{"given":"Xiaowei","family":"Gong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiwei","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianfeng","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haixiang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1319-4743","authenticated-orcid":false,"given":"Yadong","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"issue":"10223","key":"6282_CR1","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","volume":"395","author":"C Huang","year":"2020","unstructured":"Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. 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