Abstract
BackgroundThe novel coronavirus disease 2019 (COVID-19) broke out globally. Early prediction of the clinical progression was essential but still unclear. We aimed to evaluate the timeline of COVID-19 development and analyze risk factors of disease progression.MethodsIn this retrospective study, we included 333 patients with laboratory-confirmed COVID-19 infection hospitalized in the Third People’s Hospital of Shenzhen from 10 January to 10 February 2020. Epidemiological feature, clinical records, laboratory and radiology manifestations were collected and analyzed. 323 patients with mild-moderate symptoms on admission were observed to determine whether they exacerbated to severe-critically ill conditions (progressive group) or not (stable group). We used logistic regression to identify the risk factors associated with clinical progression.ResultsOf all the 333 patients, 70 (21.0%) patients progressed into severe-critically ill conditions during hospitalization and assigned to the progressive group, 253 (76.0%) patients belonged to the stable group, another 10 patients were severe before admission. we found that the clinical features of aged over 40 (3.80 [1.72, 8.52]), males (2.21 [1.20, 4.07]), with comorbidities (1.78 [1.13, 2.81]) certain exposure history (0.38 [0.20, 0.71]), abnormal radiology manifestations (3.56 [1.13, 11.40]), low level of T lymphocytes (0.99 [0.997, 0.999]), high level of NLR (0.99 [0.97, 1.01]), IL-6 (1.05 [1.03, 1.07]) and CRP (1.67 [1.12, 2.47]) were the risk factors of disease progression by logistic regression.ConclusionsThe potential risk factors of males, older age, with comorbidities, low T lymphocyte level and high level of NLR, CRP, IL-6 can help to predict clinical progression of COVID-19 at an early stage.
Highlights
The novel coronavirus disease 2019 (COVID-19) broke out globally
Two cohorts were generated in our research: 323 patients with mild-moderate symptoms on admission were observed for at least 18 days to determine whether they exacerbated to severe-critically ill conditions or not
The epidemical trends of new cases, cumulative cases and remaining cases were shown in the Fig. 1a, newly confirmed cases per day reached the peak in around 12 days after first case report and the remaining cases started to decrease after about 20 days
Summary
The novel coronavirus disease 2019 (COVID-19) broke out globally. Prediction of the clinical progression was essential but still unclear. We aimed to evaluate the timeline of COVID-19 development and analyze risk factors of disease progression. Since December 2019, a novel coronavirus disease (formerly known as 2019-nCoV and renamed COVID19) had rapidly spread throughout China, leading to a global outbreak and causing considerable public. Despite the increasing confirmed cases updated daily, the clinical investigation of affected patients was limited. In an early study in Wuhan of 138 hospitalized patients, the mortality was 4.3% and 26% of patients received intensive care unit (ICU) care [4]. Conclusions drawn from Wuhan alone might be biased and could not be representative of overall conditions due to its overwhelmingly rapid transmission and limited medical resources at the very beginning of the outbreak [6]. Infected cases from regions outside Hubei can better inform the disease’s epidemiological and clinical characteristics
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