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目的:回顾性分析重症新型冠状病毒肺炎（COVID-19）患者的临床特征与死亡相关危险因素。方法:选取2019年12月至2020年2月江汉大学附属医院收治的COVID-19患者891例，男427例，女464例。891例中重症患者582例（其中危重型159例，27%）。收集582例重症患者的人口学、实验室检查、临床特征以及治疗与预后资料，并进行单因素和多因素logistic回归分析，探讨COVID-19患者的临床特征及与死亡相关的危险因素。结果:582例中，男293例，女289例，年龄24~106岁，中位年龄为64岁；死亡组63例，其中男45例，女18例，年龄37~90岁，中位年龄为71岁。存活组519例，其中男248例，女271例，年龄24~106岁，中位年龄为62岁。582例患者平均发病时间为8 d，其中发热461例（79%），干咳358例（62%），疲劳274例（47%），气短206例（35%），咳痰155例（27%），肌肉痛或关节痛83例（14%），腹泻71例（12%），头痛29例（4%）。267例（46%）患者合并基础疾病，其中高血压194例（33%），糖尿病69例（12%），冠状动脉粥样硬化性心脏病37例（6%），肿瘤18例（3%），慢性阻塞性肺疾病5例（1%）。胸部CT示病灶累及双肺505例（87%）。582例患者入院时中位淋巴细胞计数为0.8（0.6~1.1）×10n 9/L，D-二聚体为0.5（0.4~0.8） mg/L，N端脑钠肽前体（NT-proBNP）为433（141~806） pg/L，血肌酐为70.3（56.9~87.9） μmol/L。死亡患者入院时中位淋巴细胞计数为0.5（0.4~0.8）×10n 9/L，D-二聚体为1.1（0.7~10.0） mg/L，NT-proBNP为1 479（893~5 087） pg/L，血肌酐为89.9（67.1~125.3） μmol/L。多因素logistic分析提示D-二聚体升高（n OR为1.095，95n %CI为1.045~1.148，n P<0.001）、NT-proBNP升高（n OR为4.759，95n %CI为2.437~9.291，n P<0.001）及淋巴细胞计数降低（n OR为0.180，95n %CI为0.059~0.550，n P=0.003）是COVID-19患者的死亡危险因素。n 结论:重症COVID-19患者平均发病时间为8 d，临床症状主要以发热、干咳和疲劳为主，最常合并的基础疾病是高血压，入院时多存在脏器功能受损；D-二聚体、NT-proBNP水平升高及淋巴细胞计数降低是COVID-19患者的死亡危险因素。“,”Objective:To analyze the clinical features and death-related risk factors of COVID-19.Methods:We enrolled 891 COVID-19 patients admitted to the Affiliated Hospital of Jianghan University from December 2019 to February 2020, including 427 men and 464 women. Of the 891 cases, 582 were severe or critical, including 423(73%)severe and 159 (27%) critical cases. We compared the demographics, laboratory findings, clinical characteristics, treatments and prognosis data of the 582 severe patients. Univariate and multivariate logistic regression analysis was conducted to explore the risk factors associated with death in COVID-19 patients.Results:The 582 severe patients included 293 males and 289 females, with a median age of 64(range 24 to 106). Sixty-three patients died, including 45 males and 18 females, with a median age of 71(range 37 to 90). The average onset time of the 582 patients was 8 days, of whom 461 (79%) had fever, 358 (62%) dry cough, 274 (47%) fatigue. There were 206 cases with shortness of breath (35%), 155 cases with expectoration (27%), 83 cases with muscle pain or joint pain (14%), 71 cases with diarrhea (12%), and 29 cases with headache (4%). Underlying diseases were present in 267 (46%) patients, most commonly hypertension (194, 33%), followed by diabetes (69, 12%), coronary atherosclerotic heart disease (37, 6%), tumor (18, 3%), and chronic obstructive pulmonary disease (5, 1%). Chest CT showed bilateral lung involvement in 505 patients (87%). Upon admission, the median lymphocyte count of the 582 patients was 0.8(IQR, 0.6-1.1)×10n 9/L, the median D-dimer was 0.5 (IQR, 0.4- 0.8) mg/L, the median N-terminal brain natriuretic peptide precursor (NT-proBNP) was 433 (IQR, 141- 806) pg/L, and the median creatinine was 70.3 (IQR, 56.9-87.9) μmol/L. The death group had a median lymphocyte count of 0.5 (0.4-0.8)×10 n 9/L, D-dimer 1.1 (0.7-10.0)mg/L, N-terminal brain natriuretic peptide precursor 1479(893-5 087) pg/ml, and creatinine 89.9(67.1-125.3) μmol/L. Multivariate logistic analysis showed that increased D-dimer ( n OR: 1.095, 95% n CI: 1.045-1.148, n P<0.001), increased NT-proBNP (n OR: 4.759, 95% n CI: 2.437-9.291, n P<0.001), and decreased lymphocyte count (n OR: 0.180, 95% n CI: 0.059-0.550, n P=0.003) were the risk factors of death in COVID-19 patients.n Conclusions:The average onset time of severe COVID-19 was 8 days, and the most common symptoms were fever, dry cough and fatigue. Comorbidities such as hypertension were common and mostly accompanied by impaired organ functions on admission. Higher D-dimer, higher NT-proBNP, and lower lymphocyte count were the independent risk factors of death in COVID-19 patients.