Clinical Characteristics and Predictors of Disease Progression in Severe Patients with COVID-19 Infection in Jiangsu Province, China: A Descriptive Study
| Autor: | Yishan Zheng, Xingxiang Xu, Wenjing Zhao, Hongsheng Zhao, Weiwei Wang, Quan Cao, Xudong Han, Yi Yang, Yijun Deng, Aihua Lin, Yi Shi, Jun Li, Futai Shang, Mao Huang, Qing Gu, Kexi Liu, Liang Luo |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male China medicine.medical_specialty medicine.medical_treatment Pneumonia Viral 030204 cardiovascular system & hematology Procalcitonin Prone ventilation Betacoronavirus 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Clinical Investigation 030212 general & internal medicine Pandemics Aged Retrospective Studies Aged 80 and over Mechanical ventilation Disease progression Respiratory Distress Syndrome Troponin T SARS-CoV-2 business.industry Mortality rate COVID-19 Severe patients Retrospective cohort study General Medicine Odds ratio Middle Aged Critical care Female Coronavirus Infections business Body mass index |
| Zdroj: | The American Journal of the Medical Sciences |
| ISSN: | 0002-9629 |
| DOI: | 10.1016/j.amjms.2020.05.038 |
| Popis: | Background We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province. We studied the clinical characteristics and therapies of severe cases in Jiangsu Province. Methods A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020. The improvement and deterioration subgroups were compared to identify predictors of disease progression. Results A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study. Up until April 20, 2020, the mortality of severe patients was 0%. The median age was 57 years. The average body mass index (BMI) of these patients was 25 kg/m². White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia in 13.3%, and procalcitonin levels in 88.3% of the patients were less than 0.5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and glucocorticoids therapy between the improvement and deterioration subgroups. Logistic regression analysis identified higher levels of troponin T (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.00-1.08; P=0.04), antiviral therapy with aerosol inhalation of interferon (OR: 6.33; 95% CI: 1.18-33.98; P=0.03), and the application of non-invasive mechanical ventilation (OR: 1.99; 95%CI: 1.17-3.41; P=0.01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0.11; 95% CI: 0.02-0.57; P=0.01) and early prone ventilation were associated with improvement (OR: 0.11; 95% CI: 0.01-0.98; P=0.04). Conclusions COVID-19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Early prone ventilation may be an effective treatment for severe cases. |
| Databáze: | OpenAIRE |
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