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Am J Transl Res . A disease progression prediction model and nervous system symptoms in coronavirus disease 2019 patients

tetano

Editor, Senior Moderator
Am J Transl Res


. 2020 Dec 15;12(12):8192-8207.
eCollection 2020.
A disease progression prediction model and nervous system symptoms in coronavirus disease 2019 patients


Yu Zhao[SUP] 1 [/SUP], Fuxiang Wang[SUP] 2 [/SUP], Gaolei Dong[SUP] 1 [/SUP], Qi Sheng[SUP] 1 [/SUP], Shiyan Feng[SUP] 2 [/SUP]



Affiliations
Free PMC article

Abstract

This study aimed to investigate factors affecting coronavirus disease 2019 (COVID-19) progression, also to explore the clinical features and prognosis of nervous system symptom (NSS) involved COVID-19 patients. 417 COVID-19 patients were analyzed in this retrospective study, and they were clinically classified as severe patients and non-severe patients. According to NSS involved status, COVID-19 patients were further divided into NSS patients and non-NSS patients. Elderly cases, males, common comorbidities, NSS, respiratory/cardiovascular/gastrointestinal symptoms, bilateral lesion, multifocal lesion, bacterial infection, bacterial&fungal infection were more common in severe patients compared to non-severe patients. Meanwhile, severe COVID-19 patients showed increased baseline APTT, TT, D-dimer, CRP, ESR, CK-MB, creatine kinase, AST, ALT, creatinine, but decreased baseline platelet level, lymphocyte, albumin, GFR compared to non-severe patients. Notably, the continuous differences of lymphocyte, D-dimer, CRP, AST, ALT, albumin, GFR between severe patients and non-severe patients during treatment were observed. Age, NSS, bacterial & fungal infection, CRP and creatinine were further identified as independent risk factors for severe COVID-19, which could predict severe COVID-19 with area under curve of 0.861. Furthermore, severe patients presented with worse prognosis. Regrading NSS patients, they were related to older age, surgery history, diabetes comorbidities, respiratory/cardiovascular/gastrointestinal symptoms, bilateral lesion, multifocal lesion, bacterial infection, bacterial&fungal infection and more dysregulated laboratory indexes compared to non-NSS patients. Besides, NSS patients were correlated with poor prognosis to some extent. More intensive attention should be paid to COVID-19 patients with severe-disease risk factors and those with NSS involvement, in case of rapid deterioration.

Keywords: Coronavirus disease 2019; disease progression predicting model; disease severity; laboratory indexes; nervous system symptom; prognosis.
 
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