Predictive factors for disease progression in hospitalized patients with coronavirus disease 2019 in Wuhan, China

J Clin Virol. 2020 Jun:127:104392. doi: 10.1016/j.jcv.2020.104392. Epub 2020 Apr 28.

Abstract

Background: A few studies have revealed the clinical characteristics of hospitalized patients with COVID-19. However, predictive factors for the outcomes remain unclear.

Objective: Attempted to determine the predictive factors for the poor outcomes of patients with COVID-19.

Study design: This is a single-center, retrospective study. Clinical, laboratory, and treatment data were collected and analyzed from 111 hospitalized patients with laboratory-confirmed COVID-19 in Union Hospital. The gathered data of discharged and deteriorated patients were compared.

Results: Among these 111 patients, 93 patients were discharged and 18 patients were deteriorated. The lymphocyte count (0.56 G/L [0.47-0.63] vs 1.30 G/L [0.95-1.65]) was lower in the deteriorated group than those in the discharged group. The numbers of pulmonary lobe involved (5.00 [5.00-5.00] vs 4.00 [2.00-5.00]), serum C-reactive protein (CRP, 79.52 mg/L [61.25-102.98] vs 7.93 mg/L [3.14-22.50]), IL-6 (35.72 pg/mL [9.24-85.19] vs 5.09 pg/mL [3.16-9.72]), and IL-10 (5.35 pg/mL [4.48-7.84] vs 3.97 pg/mL [3.34-4.79]) concentrations in deteriorated patients were elevated compared with discharged patients. Multivariate logistic regression analysis showed that male gender (OR, 24.8 [1.8-342.1]), comorbidity (OR, 52.6 [3.6-776.4]), lymphopenia (OR, 17.3 [1.1-261.8]), and elevated CRP (OR, 96.5 [4.6-2017.6]) were the independent risk factors for the poor prognosis in COVID-19 patients.

Conclusions: This finding would facilitate the early identification of high-risk COVID-19 patients.

Keywords: Coronavirus disease 2019; Predictive factors; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • C-Reactive Protein / analysis
  • COVID-19
  • Comorbidity
  • Coronavirus Infections / blood
  • Coronavirus Infections / diagnosis*
  • Cytokines / blood
  • Disease Progression*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / diagnosis*
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Sex Factors

Substances

  • Cytokines
  • C-Reactive Protein