Department of Infectious Diseases, Fuyang Second People's Hospital, Fuyang, Anhui, China (mainland).
Department of Public Health, Lu'an Center for Disease Control and Prevention, Lu'an, Anhui, China (mainland).
Med Sci Monit. 2020 Sep 23;26:e927167. doi: 10.12659/MSM.927167.
BACKGROUND Early and rapid identification of severe coronavirus disease 2019 (COVID-19) cases is important. The present study aimed to investigate the predictors of disease severity and thus determine the trends for disease progression early. MATERIAL AND METHODS Patients with COVID-19 were recruited from Fuyang Second People's Hospital from January to February 2020. Patients' demographic, epidemiological, and clinical data were collected, and the relationships between these variables and disease severity were analyzed. RESULTS A total of 158 cases were included according to COVID-19 diagnosis, and the treatment schemes were analyzed for identification of early indicators affecting COVID-19 progression. Severe cases accounted for 18.99% of the diagnosed cases. Analysis showed that patients' age (χ²=10.640,=0.041); the time interval between onset and diagnosis (χ²=7.278, P=0.026); the source of cases (χ²=5.557, P=0.018); fever (χ²=5.676, P=0.014); dyspnea (χ²=113.085, P<0.001); muscle or joint pain (χ²=3.900, P=0.048); chest pain (χ²=13.446, P=0.006); the levels of lymphocytes (t=2.917, P=0.014), C-reactive protein (U=730.00, P<0.001), and aspartate aminotransferase (U=1235.00, P=0.002); damage in both lungs within 3 days of admission (χ²=7.632, P=0.003); and diabetes (χ²=6.675, P=0.010) were significantly correlated with the trend of intensification. CONCLUSIONS Older age, a long time interval from onset to diagnosis, imported cases from an affected area, dyspnea, muscle or joint pain, chest pain during the course of the disease, reduced lymphocytes, elevated C-reactive protein, computed tomography scan showing damage to both lungs within 3 days of admission, and diabetes mellitus are predictors for severe COVID-19.
早期快速识别严重的 2019 年冠状病毒病(COVID-19)病例非常重要。本研究旨在探讨疾病严重程度的预测因素,从而早期确定疾病进展的趋势。
从 2020 年 1 月至 2 月,我们从富阳市第二人民医院招募了 COVID-19 患者。收集了患者的人口统计学、流行病学和临床数据,并分析了这些变量与疾病严重程度之间的关系。
根据 COVID-19 诊断,共纳入 158 例患者,并对治疗方案进行了分析,以确定影响 COVID-19 进展的早期指标。重症病例占确诊病例的 18.99%。分析表明,患者年龄(χ²=10.640,P=0.041);发病至诊断的时间间隔(χ²=7.278,P=0.026);病例来源(χ²=5.557,P=0.018);发热(χ²=5.676,P=0.014);呼吸困难(χ²=113.085,P<0.001);肌肉或关节疼痛(χ²=3.900,P=0.048);胸痛(χ²=13.446,P=0.006);淋巴细胞水平(t=2.917,P=0.014)、C 反应蛋白(U=730.00,P<0.001)和天冬氨酸转氨酶(U=1235.00,P=0.002);入院后 3 天内双肺损伤(χ²=7.632,P=0.003);以及糖尿病(χ²=6.675,P=0.010)与病情加重趋势显著相关。
年龄较大、从发病到诊断的时间间隔较长、来自疫区的输入性病例、呼吸困难、肌肉或关节疼痛、胸痛、疾病过程中淋巴细胞减少、C 反应蛋白升高、入院后 3 天内 CT 扫描显示双肺损伤以及糖尿病是 COVID-19 重症的预测因素。