AUTHOR=Zhang Yanpei , Xiao Lu-shan , Li Pu , Zhu Hongbo , Hu Chenyi , Zhang Wen-Feng , Sun Qing-can , Shen Meng-ying , Liu Shan-shan , Zhang Wan-li , Zeng Han-yi , Gong Mengchun , Liu Li , He Yu-Lin , Zhu Hong
TITLE=Clinical Characteristics of Patients With Progressive and Non-progressive Coronavirus Disease 2019: Evidence From 365 Hospitalised Patients in Honghu and Nanchang, China
JOURNAL=Frontiers in Medicine
VOLUME=7
YEAR=2020
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.556818
DOI=10.3389/fmed.2020.556818
ISSN=2296-858X
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.