Potential Predictors for Disease Progression and Medication Evaluation of 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China
35 Pages Posted: 23 Mar 2020More...
Background: There are limited studies exploring the early warning indicators for mortality and disease progression, and the association between current treatment and outcome of NCIP.
Methods: In this retrospective, single-center study, we consecutively enrolled 262 hospitalized patients with confirmed NCIP at Wuhan Jinyintan Hospital from Dec 29, 2019 to Feb 17, 2020. Apart from epidemiological, demographic and radiological data, baseline and dynamic change of laboratory, clinical and therapeutic data were compared between patients with different prognosis.
Findings: Up to final date of follow-up, 86 (32·8%) patients died and 176 (67·2%) survived, of which 173 (66.0%) were discharged. Compared with survivors, non-survivors were elder (66.5 vs 49.9, p <0.0001), had more comorbidities and more abnormalities in follow-up laboratory tests, including persistent lower levels of lymphocytes, platelets and prealbumin, increasingly higher levels of myoglobin. Higher percentage of non-survivors received respiratory support. There was an increase in inflammatory markers before mechanical ventilation in a total of 79 patients suffering hypoxemia progression, including leukocytes, high-sensitivity-CRP, interleukin-6 and ferritin. More patients were given corticosteroids (61·6% vs 24·4%, p <0·0001) or lopinavir-ritonavir (20·9% vs 11·9%, p =0·082) in non-survivors, while the duration of the therapies showed non-significant difference.
Interpretation: Elder patients with more comorbidities and abnormalities in lymphocytes, platelets, prealbumin and myoglobin indicated poor prognosis of NCIP. Leukocytes, high-sensitivity-CRP, IL-6 and ferritin may predict the progression of disease. No evidence supported the effects of corticosteroids and lopinavir-ritonavir in NCIP treatment.
Funding Statement: This work was funded in part by a grant from Innovative research team of high-level local universities in Shanghai.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: The Ethics Commission of Jinyintan Hospital approved this study (KY-2020-03.01). Written informed consent was waived due to the rapid emergence of this infectious disease.
Keywords: novel coronavirus-infected pneumonia; laboratory; therapeutics; progression; outcome
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