tetano
Editor, Senior Moderator
Am J Med Sci
. 2020 Aug;360(2):120-128.
doi: 10.1016/j.amjms.2020.05.038. Epub 2020 Jun 1.
Clinical Characteristics and Predictors of Disease Progression in Severe Patients with COVID-19 Infection in Jiangsu Province, China: A Descriptive Study
Mao Huang[SUP] 1 [/SUP], Yi Yang[SUP] 2 [/SUP], Futai Shang[SUP] 3 [/SUP], Yishan Zheng[SUP] 4 [/SUP], Wenjing Zhao[SUP] 5 [/SUP], Liang Luo[SUP] 6 [/SUP], Xudong Han[SUP] 7 [/SUP], Aihua Lin[SUP] 8 [/SUP], Hongsheng Zhao[SUP] 9 [/SUP], Qing Gu[SUP] 10 [/SUP], Yi Shi[SUP] 11 [/SUP], Jun Li[SUP] 12 [/SUP], Xingxiang Xu[SUP] 13 [/SUP], Kexi Liu[SUP] 14 [/SUP], YiJun Deng[SUP] 15 [/SUP], Quan Cao[SUP] 16 [/SUP], Weiwei Wang[SUP] 17 [/SUP]
Affiliations
Abstract
Background: We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2, a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province. We studied the clinical characteristics and therapies of severe cases in Jiangsu Province.
Methods: A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020. The improvement and deterioration subgroups were compared to identify predictors of disease progression.
Results: A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study. Up until April 20, 2020, the mortality of severe patients was 0%. The median age was 57 years. The average body mass index of these patients was 25 kg/m?. White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia in 13.3% and procalcitonin levels in 88.3% of the patients were less than 0.5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and GCs therapy between the improvement and deterioration subgroups. Logistic regression analysis identified higher levels of troponin T (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.00-1.08; P = 0.04), antiviral therapy with aerosol inhalation of interferon (OR: 6.33; 95% CI: 1.18-33.98; P = 0.03), and the application of non-invasive mechanical ventilation (OR: 1.99; 95%CI: 1.17-3.41; P = 0.01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0.11; 95% CI: 0.02-0.57; P = 0.01) and early prone ventilation were associated with improvement (OR: 0.11; 95% CI: 0.01-0.98; P = 0.04).
Conclusions: COVID-19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Early prone ventilation may be an effective treatment for severe cases.
Keywords: COVID-19; Critical care; Disease progression; Severe patients.
. 2020 Aug;360(2):120-128.
doi: 10.1016/j.amjms.2020.05.038. Epub 2020 Jun 1.
Clinical Characteristics and Predictors of Disease Progression in Severe Patients with COVID-19 Infection in Jiangsu Province, China: A Descriptive Study
Mao Huang[SUP] 1 [/SUP], Yi Yang[SUP] 2 [/SUP], Futai Shang[SUP] 3 [/SUP], Yishan Zheng[SUP] 4 [/SUP], Wenjing Zhao[SUP] 5 [/SUP], Liang Luo[SUP] 6 [/SUP], Xudong Han[SUP] 7 [/SUP], Aihua Lin[SUP] 8 [/SUP], Hongsheng Zhao[SUP] 9 [/SUP], Qing Gu[SUP] 10 [/SUP], Yi Shi[SUP] 11 [/SUP], Jun Li[SUP] 12 [/SUP], Xingxiang Xu[SUP] 13 [/SUP], Kexi Liu[SUP] 14 [/SUP], YiJun Deng[SUP] 15 [/SUP], Quan Cao[SUP] 16 [/SUP], Weiwei Wang[SUP] 17 [/SUP]
Affiliations
- PMID: 32709280
- DOI: 10.1016/j.amjms.2020.05.038
Abstract
Background: We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2, a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province. We studied the clinical characteristics and therapies of severe cases in Jiangsu Province.
Methods: A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020. The improvement and deterioration subgroups were compared to identify predictors of disease progression.
Results: A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study. Up until April 20, 2020, the mortality of severe patients was 0%. The median age was 57 years. The average body mass index of these patients was 25 kg/m?. White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia in 13.3% and procalcitonin levels in 88.3% of the patients were less than 0.5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and GCs therapy between the improvement and deterioration subgroups. Logistic regression analysis identified higher levels of troponin T (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.00-1.08; P = 0.04), antiviral therapy with aerosol inhalation of interferon (OR: 6.33; 95% CI: 1.18-33.98; P = 0.03), and the application of non-invasive mechanical ventilation (OR: 1.99; 95%CI: 1.17-3.41; P = 0.01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0.11; 95% CI: 0.02-0.57; P = 0.01) and early prone ventilation were associated with improvement (OR: 0.11; 95% CI: 0.01-0.98; P = 0.04).
Conclusions: COVID-19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Early prone ventilation may be an effective treatment for severe cases.
Keywords: COVID-19; Critical care; Disease progression; Severe patients.