Analysis of blood samples from 42 patients with varying degrees of infection during the epidemic of COVID-19: a retrospective study.

Abstract

Blood samples from 42 patients with coronavirus disease 2019 (COVID-19) with varying degrees of infection were examined to further explore the relationship between clinical features, immune factors and COVID-19, as well as the diagnostic and predictive values of clinical features and immune factors in severe disease progression. This study included 42 nucleic acid-positive COVID-19 patients admitted to the First Hospital of Jiaxing from January 26, 2020 to February 21, 2020, who were divided into mild-moderate group and severe group based on respiratory rate, resting oxygen saturation and alveolar oxygen partial pressure/O2 inhalation. On February 21, 2020, clinical data including sex, age, body mass index (BMI), past medical history, clinical symptoms, hematology indexes [white blood cell (WBC); neutrophil (NEUT); lymphocyte (LYM); C-reactive protein (CRP)] were collected. The chi-square test was used to compare the clinical data differences between the two groups, so as to perform comparative analysis in the context of serious disease development. There were 8 cases of severe disease, and 34 cases of mild and moderate symptoms. Comparative analysis showed that patients with advanced age (≥60 years, OR =5.800, P=0.0286), history of hypertension (OR =5.800, P=0.0286) and pulmonary lobe lesions (≥4, OR =6.273, P=0.0270) were more likely to develop serious diseases. In addition, according to clinical symptoms, chest pain was more prominent in patients with severe disease. Laboratory tests showed that levels of WBC (severe 4.96±1.76 vs. mild-moderate 5.45±2.01, P=0.5300), NEUT (severe 3.56±1.44 vs. mild-moderate 3.94±1.87, P=0.5945) and LYM (severe 0.91±0.25 vs. mild-moderate 1.11±0.51, P=0.2903) were normal or decreased, but CRP level (severe 31.03±9.38 vs. mild-moderate 12.53±15.73, P=0.0029) was obviously increased, especially in patients with severe disease, with statistically significant difference between groups. Patients with hypertension and advanced age are more likely to develop deteriorate with COVID-19, and the number of lung lobes with lesions and chest pain may indicate disease progression. Notably, CRP level is significantly elevated in severe disease and it may be closely related to COVID-19 progression.