Department of Hepatology, Shenzhen Third People's Hospital, National Clinical Research Center for Infectious Disease, The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, 29 Bulan Road, Shenzhen, 518112, Guangdong, China.
Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Transl Med. 2020 Jul 3;18(1):270. doi: 10.1186/s12967-020-02423-8.
The 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.
In 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.
Of 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.
The 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.
2019 年新型冠状病毒病（COVID-19）在全球爆发。早期预测临床进展至关重要，但仍不清楚。我们旨在评估 COVID-19 发展的时间线，并分析疾病进展的危险因素。
在这项回顾性研究中，我们纳入了 2020 年 1 月 10 日至 2 月 10 日期间在深圳市第三人民医院住院的 333 例实验室确诊的 COVID-19 感染患者。收集并分析了流行病学特征、临床记录、实验室和影像学表现。入院时为轻中度症状的 323 例患者观察其是否恶化至严重-危急情况（进展组）或未恶化（稳定组）。我们使用逻辑回归识别与临床进展相关的危险因素。
在所有 333 例患者中，70 例（21.0%）患者在住院期间进展为严重-危急情况，归入进展组，253 例（76.0%）患者属于稳定组，另有 10 例患者在入院前即为重症。我们发现，年龄超过 40 岁（3.80 [1.72, 8.52]）、男性（2.21 [1.20, 4.07]）、合并症（1.78 [1.13, 2.81]）、某些暴露史（0.38 [0.20, 0.71]）、异常影像学表现（3.56 [1.13, 11.40]）、低水平 T 淋巴细胞（0.99 [0.997, 0.999]）、高水平中性粒细胞与淋巴细胞比值（0.99 [0.97, 1.01]）、IL-6（1.05 [1.03, 1.07]）和 CRP（1.67 [1.12, 2.47]）是通过逻辑回归确定的疾病进展的危险因素。
男性、年龄较大、合并症、低 T 淋巴细胞水平和高中性粒细胞与淋巴细胞比值、CRP、IL-6 等潜在危险因素有助于早期预测 COVID-19 的临床进展。
