Exploring the Law of Development and Prognostic Factors of Common and Severe COVID-19: A Retrospective Case-Control Study in 122 Patients with Complete Course of Disease
23 Pages Posted: 24 Mar 2020More...
Background: To explore the risk factors for poor prognosis of coronavirus disease 2019 (COVID-19), perform risk stratification for patients and depict the dynamic change of different laboratory indices throughout the course of disease.
Methods: We conducted a retrospective study of 122 inpatients diagnosed with COVID-19 from January 13 to February 25, 2020. All the patients were divided into common group (n=43) and severe group (n=79), and severe group was subdivided into severe-recovered group (n=40) and severe-progression group (n=39). A complete course of disease was closely monitered and recorded for each patient to compare the differences between severe group and common group, find out the risk factors for poor prognosis by univariate and multivariate analysis, and analyze the dynamic change of some laboratory indices during the course of disease.
Findings: The baseline neutrophil-to-lymphocyte ratio (NLR) and Lactate dehydrogenase (LDH) were identified as the independent risk factors for severe COVID-19 conditions, and the NLR-LDH grading system was developed to perform risk stratification. The baseline C-reactive protein (CRP) and B-type natriuretic peptide (BNP) were identified as the independent predictors for disease progression of severe patients. The laboratory indices of severe-progression group began to turn abnormal in about the first week after illness onset, reached its peak in the third week and remained far above reference line.
Interpretation: The NLR-LDH grading system that we proposed was a useful prognostic tool for the early detection of severe patients with COVID-19. And in the severe patients, CRP and BNP seemed to be helpful for predicting the disease progression or death, and their cardiac function required more attention. In addition, certain inflammatory and organ function indices in severe patients might indicate poor prognosis if they are much higher than reference line and continue to rise more than two weeks after illness onset.
Funding Statement: None.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: This retrospective, one-centre study was reviewed and approved by the Medical Ethical Committee of Jinyintan Hospital, and written informed consent was not obtained promptly due to urgent need for clinical data.
Keywords: coronavirus disease 2019; prognostic factors; neutrophil-to-lymphocyte ratio; cardiac function; laboratory indices
Suggested Citation: Suggested Citation