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Potential Predictors for Disease Progression and Medication Evaluation of 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

35 Pages Posted: 23 Mar 2020

See all articles by Sheng Zhang

Sheng Zhang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Jingya Zhao

Shanghai Jiao Tong University (SJTU) - Department of Pulmonary and Critical Care Medicine

Zhixiong Wu

Fudan University - Department of Surgical Intensive Care Unit

You Shang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Critical Care Medicine

Junhua Zheng

Shanghai Jiao Tong University (SJTU) - Department of Evidence-Based Medicine; Shanghai Jiao Tong University (SJTU) - Department of Urology

Mei Meng

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Jiao Liu

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Yanping Xu

Shanghai Jiao Tong University (SJTU) - Department of Respiratory and Critical Care Medicine

Guang Li

Wuhan University - Department of Critical Care Medicine

Mengmeng Shi

Shanghai Jiao Tong University (SJTU) - Department of Pulmonary and Critical Care Medicine

Mengyuan Diao

Zhejiang University - Department of Critical Care Medicine

Limin Chen

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Tao Wang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Sisi Huang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Wenzhe Li

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Qingyuan Yang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Zhenliang Wen

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Lidi Zhang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Xuan Dong

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory

Jie-ming Qu

Shanghai Jiao Tong University (SJTU) - Department of Respiratory and Critical Care Medicine

Dechang Chen

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

More...

Abstract

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

Suggested Citation

Zhang, Sheng and Zhao, Jingya and Wu, Zhixiong and Shang, You and Zheng, Junhua and Meng, Mei and Liu, Jiao and Xu, Yanping and Li, Guang and Shi, Mengmeng and Diao, Mengyuan and Chen, Limin and Wang, Tao and Huang, Sisi and Li, Wenzhe and Yang, Qingyuan and Wen, Zhenliang and Zhang, Lidi and Dong, Xuan and Qu, Jie-ming and Chen, Dechang, Potential Predictors for Disease Progression and Medication Evaluation of 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China (3/7/2020). Available at SSRN: https://ssrn.com/abstract=3551399 or http://dx.doi.org/10.2139/ssrn.3551399

Sheng Zhang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Jingya Zhao

Shanghai Jiao Tong University (SJTU) - Department of Pulmonary and Critical Care Medicine

Shanghai
China

Zhixiong Wu

Fudan University - Department of Surgical Intensive Care Unit

Shanghai
China

You Shang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Critical Care Medicine ( email )

Wuhan
China

Junhua Zheng

Shanghai Jiao Tong University (SJTU) - Department of Evidence-Based Medicine ( email )

Shanghai
China

Shanghai Jiao Tong University (SJTU) - Department of Urology

China

Mei Meng

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Jiao Liu

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Yanping Xu

Shanghai Jiao Tong University (SJTU) - Department of Respiratory and Critical Care Medicine

China

Guang Li

Wuhan University - Department of Critical Care Medicine

Wuhan
China

Mengmeng Shi

Shanghai Jiao Tong University (SJTU) - Department of Pulmonary and Critical Care Medicine

Shanghai
China

Mengyuan Diao

Zhejiang University - Department of Critical Care Medicine

Hangzhou, Zhejiang
China

Limin Chen

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Tao Wang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Sisi Huang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Wenzhe Li

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Qingyuan Yang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Zhenliang Wen

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Lidi Zhang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

No 197, Rui Jin 2nd road
Shanghai, 200025
China

Xuan Dong

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory ( email )

China

Jie-ming Qu

Shanghai Jiao Tong University (SJTU) - Department of Respiratory and Critical Care Medicine ( email )

China

Dechang Chen (Contact Author)

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine ( email )

No 197, Rui Jin 2nd road
Shanghai, 200025
China

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