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J Clin Virol . Factors associated with clinical outcomes in patients with Coronavirus Disease 2019 in Guangzhou, China

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  • J Clin Virol . Factors associated with clinical outcomes in patients with Coronavirus Disease 2019 in Guangzhou, China


    J Clin Virol


    . 2020 Oct 14;133:104661.
    doi: 10.1016/j.jcv.2020.104661. Online ahead of print.
    Factors associated with clinical outcomes in patients with Coronavirus Disease 2019 in Guangzhou, China


    Chunliang Lei 1 , Weiyin Lin 1 , Xilong Deng 1 , Fengyu Hu 1 , Fengjuan Chen 1 , Weiping Cai 1 , Yueping Li 1 , Chunyan Wen 1 , Yujuan Guan 1 , Jian Wang 1 , Xiaoting Chen 1 , Yi Cao 1 , Feng Li 1 , Xiaoping Tang 2 , Linghua Li 3



    AffiliationsFree PMC article

    Abstract

    Background: Coronavirus Disease 2019 (COVID-19) is threatening billions of people. We described the clinical characteristics and explore virological and immunological factors associated with clinical outcomes.
    Methods: 297 COVID-19 patients hospitalized in Guangzhou Eighth People's Hospital between January 20 and February 20, 2020 were included. Epidemiological, clinical and laboratory data were collected and analyzed. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in respiratory tract, blood samples and digestive tract was detected and lymphocyte subsets were tested periodically.
    Result: Among the 297 patients (median age of 48 years), 154 (51.9 %) were female, 245 (82.5 %) mild/moderate cases, and 52 (17.5 %) severe/critical cases. 270 patients were detected for SARS-CoV-2 RNA in anal swabs and/or blood samples, and the overall positive rate was 23.0 % (62/270), higher in severe/critical cases than in mild/moderate cases (52.0 % vs. 16.4 %, P < 0.001). The CD4/CD8 ratio on admission was significantly higher in severe/critical cases than in mild/moderate cases (1.84 vs. 1.50, P = 0.022). During a median follow-up period of 17 days, 36 (12.1 %) patients were admitted to intensive care unit (ICU), 16 (5.4 %) patients developed respiratory failure and underwent mechanical ventilation, four (1.3 %) patients needed extracorporeal membrane oxygenation (ECMO), only one (0.34 %) patients died of multiple organ failure. Detectable SARS-CoV-2 RNA in anal swabs and/or blood samples, as well as higher CD4/CD8 ratio were independent risk factors of respiratory failure and ICU admission.
    Conclusions: Most of COVID-19 patients in Guangzhou are mild/moderate, and presence of extrapulmonary virus and higher CD4/CD8 ratio are associated with higher risk of worse outcomes.

    Keywords: CD4/CD8 ratio; COVID-19; Extrapulmonary; ICU admission; Respiratory failure; SARS-CoV-2; Virus.

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