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Front Med (Lausanne)
. 2020 Nov 16;7:556818.
doi: 10.3389/fmed.2020.556818. eCollection 2020.
Clinical Characteristics of Patients With Progressive and Non-progressive Coronavirus Disease 2019: Evidence From 365 Hospitalised Patients in Honghu and Nanchang, China
Yanpei Zhang 1 2 , Lu-Shan Xiao 2 , Pu Li 3 , Hongbo Zhu 2 4 , Chenyi Hu 2 , Wen-Feng Zhang 5 , Qing-Can Sun 2 , Meng-Ying Shen 2 , Shan-Shan Liu 2 , Wan-Li Zhang 2 , Han-Yi Zeng 2 , Mengchun Gong 6 , Li Liu 1 2 , Yu-Lin He 7 , Hong Zhu 8
Affiliations
- PMID: 33304910
- PMCID: PMC7701171
- DOI: 10.3389/fmed.2020.556818
Abstract
Background: Coronavirus disease (COVID-19) has swept around the globe and led to a worldwide catastrophe. Studies examining the disease progression of patients with non-severe disease on admission are scarce but of profound importance in the early identification of patients at a high risk of deterioration. Objectives: To elucidate the differences in clinical characteristics between patients with progressive and non-progressive COVID-19 and to determine the risk factors for disease progression. Study design: Clinical data of 365 patients with non-severe COVID-19 from 1 January 2020 to 18 March 2020 were retrospectively collected. Patients were stratified into progressive and non-progressive disease groups. Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for disease progression. Results: Compared with patients with non-progressive disease, those who progressed to severe COVID-19 were older and had significantly decreased lymphocyte and eosinophil counts; increased neutrophil and platelet counts; lower albumin levels; higher levels of lactate dehydrogenase, C-reactive protein (CRP), creatinine, creatinine kinase, and urea nitrogen; and longer prothrombin times. Hypertension, fever, fatigue, anorexia, bacterial coinfection, bilateral patchy shadowing, antibiotic and corticosteroid administration, and oxygen support had a significantly higher incidence among patients with progressive disease. A significantly longer duration of hospital stay was also observed in patients with progressive disease. Bilateral patchy shadowing (OR = 4.82, 95% CI: 1.33-17.50; P = 0.017) and elevated levels of creatinine (OR =6.24, 95% CI: 1.42-27.40; P = 0.015), and CRP (OR = 7.28, 95% CI: 2.56-20.74; P < 0.001) were independent predictors for disease progression. Conclusion: The clinical characteristics of patients with progressive and non-progressive COVID-19 were significantly different. Bilateral patchy shadowing and increased levels of creatinine, and CRP were independent predictors of disease progression.
Keywords: C-reactive protein; bilateral patchy shadowing; coronavirus disease 2019; creatinine; creatinine kinase; disease progression; severe acute respiratory syndrome coronavirus 2.