Abstract
BackgroundEpidemiological and clinical features of patients with corona virus disease 2019 (COVID-19) were well delineated. However, no researches described the patients complicated with pleural effusion (PE). In the present study, we aimed to clinically characterize the COVID-19 patients complicated with PE and to create a predictive model on the basis of PE and other clinical features to identify COVID-19 patients who may progress to critical condition.MethodsThis retrospective study examined 476 COVID-19 inpatients, involving 153 patients with PE and 323 without PE. The data on patients’ past history, clinical features, physical checkup findings, laboratory results and chest computed tomography (CT) findings were collected and analyzed. LASSO regression analysis was employed to identify risk factors associated with the severity of COVID-19.ResultsLaboratory findings showed that patients with PE had higher levels of white blood cells, neutrophils, lactic dehydrogenase, C-reactive protein and D-dimer, and lower levels of lymphocytes, platelets, hemoglobin, partial pressure of oxygen and oxygen saturation. Meanwhile, patients with PE had higher incidence of severe or critical illness and mortality rate, and longer hospital stay time compared to their counterparts without pleural effusion. Moreover, LASSO regression analysis exhibited that pleural effusion, lactic dehydrogenase (LDH), D-dimer and total bilirubin (TBIL) might be risk factors for critical COVID-19.ConclusionsPleural effusion could serve as an indicator for severe inflammation and poor clinical outcomes, and might be a complementary risk factor for critical type of COVID-19.
Highlights
Epidemiological and clinical features of patients with corona virus disease 2019 (COVID-19) were well delineated
Patients were excluded from the study if they met any of the following criteria: (1) age < 18 years; (2) relevant data were not available; (3) pleural effusion (PE) was caused by chronic heart failure, malignant tumors, tuberculosis and other infection diseases by clinical history, imaging examination or thoracentesis
Risk factors for critical COVID-19 A total of 48 variables were subjected to the LASSO regression analysis, and the results showed that PE, lactic dehydrogenase (LDH), D-dimer and total bilirubin (TBIL) were significantly related to incidence of critical COVID-19 when the partial likelihood deviance was smallest (Fig. 4a and b)
Summary
Epidemiological and clinical features of patients with corona virus disease 2019 (COVID-19) were well delineated. We aimed to clinically characterize the COVID-19 patients complicated with PE and to create a predictive model on the basis of PE and other clinical features to identify COVID-19 patients who may progress to critical condition. The diagnosis of COVID-19 was established on the basis of contact history, clinical features, imaging findings and results of RT-PCR tests [7]. Given the wide clinical spectrum of COVID-19, understanding the factors that can predict disease severity were essential since this would help frontline clinical staff to stratify patients with increased confidence [8]. Pleural effusion (PE), lung cavitation, lymphadenopathy and calcification were rarely seen in COVID-19 patients [9,10,11]. Previous studies demonstrated that PE exerted a significant influence on the final outcome of patients suffering from acute
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
