Wang Guyi, Wu Chenfang, Zhang Quan, Wu Fang, Yu Bo, Lv Jianlei, Li Yiming, Li Tiao, Zhang Siye, Wu Chao, Wu Guobao, Zhong Yanjun
Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Critical Care Medicine, The First Hospital of Changsha, Changsha, China.
Open Forum Infect Dis. 2020 Apr 29;7(5):ofaa153. doi: 10.1093/ofid/ofaa153. eCollection 2020 May.
Clinical findings indicated that a fraction of coronavirus disease 2019 (COVID-19) patients diagnosed as mild early may progress to severe cases. However, it is difficult to distinguish these patients in the early stage. The present study aimed to describe the clinical characteristics of these patients, analyze related factors, and explore predictive markers of the disease aggravation.
Clinical and laboratory data of nonsevere adult COVID-19 patients in Changsha, China, were collected and analyzed on admission. A logistic regression model was adopted to analyze the association between the disease aggravation and related factors. The receiver operating characteristic curve (ROC) was utilized to analyze the prognostic ability of C-reactive protein (CRP).
About 7.7% (16/209) of nonsevere adult COVID-19 patients progressed to severe cases after admission. Compared with nonsevere patients, the aggravated patients had much higher levels of CRP (median [range], 43.8 [12.3-101.9] mg/L vs 12.1 [0.1-91.4] mg/L; = .000). A regression analysis showed that CRP was significantly associated with aggravation of nonsevere COVID-19 patients, with an area under the curve of 0.844 (95% confidence interval, 0.761-0.926) and an optimal threshold value of 26.9 mg/L.
CRP could be a valuable marker to anticipate the possibility of aggravation of nonsevere adult COVID-19 patients, with an optimal threshold value of 26.9 mg/L.
临床研究结果表明，一部分早期被诊断为轻症的2019冠状病毒病（COVID-19）患者可能会进展为重症。然而，在疾病早期很难区分出这些患者。本研究旨在描述这类患者的临床特征，分析相关因素，并探索疾病加重的预测指标。
收集并分析了中国长沙非重症成年COVID-19患者入院时的临床和实验室数据。采用逻辑回归模型分析疾病加重与相关因素之间的关联。利用受试者工作特征曲线（ROC）分析C反应蛋白（CRP）的预后能力。
约7.7%（16/209）的非重症成年COVID-19患者在入院后进展为重症。与非重症患者相比，病情加重的患者CRP水平要高得多（中位数[范围]，43.8[12.3 - 101.9]mg/L对12.1[0.1 - 91.4]mg/L；P = .000）。回归分析显示，CRP与非重症COVID-19患者病情加重显著相关，曲线下面积为0.844（95%置信区间，0.761 - 0.926），最佳阈值为26.9mg/L。
CRP可能是预测非重症成年COVID-19患者病情加重可能性的一个有价值的指标，最佳阈值为26.9mg/L。
