Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study

Wang, Dan; Li, Ruifang; Wang, Juan; Jiang, Quanyuan; Gao, Chang; Yang, Juan; Ge, Lintong; Hu, Qing

doi:10.1186/s12879-020-05242-w

Cited by 128 publications

(180 citation statements)

References 16 publications

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“…The fatal outcomes are correlated with the age of more than 65 years, pre-existing underlying diseases, the presence of secondary infections and the rises in blood in ammatory indicators. The disease severity is correlated with underling diseases such as diabetes, renal disease, and chronic pulmonary disease and abnormality of higher white blood cell counts, lower lymphocyte counts, and increased C-reactive protein [13][14][15]. Based on a solved epidemic in this study, we also found that the age and underlying comorbidities were the major factors associated with the disease severity.…”

Section: Benign Outcomes-associated Factors In Treatmentssupporting

confidence: 53%

“…The age of more than 65 years, pre-existing underlying diseases, the presence of secondary bacterial infections and the rises in blood in ammatory indicators are predictors of fatal outcomes. In addition, some studies have shown that patients with severe infection are more likely to have diabetes, renal disease, and chronic pulmonary disease and have higher white blood cell counts, lower lymphocyte counts, and increased C-reactive protein [13][14][15]. The intensive care unit admission is predicted by raises in leukocyte count, alanine aminotransferase, aspartate transaminase, lactate dehydrogenase and procalcitonin [16].…”

Section: Introductionmentioning

confidence: 99%

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Benign Clinical and Epidemiological Outcomes-Associated Factors of COVID-19 from a Solved Epidemic with a Low Case Fatality Rate

Hu¹,

Liu²,

He³

et al. 2020

Preprint

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Background: Since December 2019, COVID-19 has been confirmed in more than18.8 million patients and leads to 0.70 million deaths worldwide. The mortality and disease severity predictors of COVID-19 have been investigated in many studies. However, they are based on early or partial datasets from high epidemic areas. Here, we retrospect benign clinical and epidemiological outcomes-associated factors from a solved epidemic in a low epidemic area. Methods: All 98 laboratory-confirmed COVID-19 patients in a local epidemic (Zhuhai, China) from January 17, 2020 to March 10, 2020 were enrolled. Data were updated until all patients having final outcomes. Results: Patients were all hospitalized. The case fatality rate was 1.0%. There were no local secondary infection cases. The median age was 46.3 years. Underlying diseases were found in 33.7% patients. The severe/critical rate was 19.4%. The mean period from disease onset to admission was 4.4 days. Compared with serious/critical cases, mild/common cases on admission were much younger, lacks of comorbidities and normal in functions of vital organs and indicators of secondary bacterial infections. The lymphocyte counts in serious/critical cases began to be significantly lower 3 days before their identification dates. The absence of lymphopenia before the eighth day from disease onset can exclude the possibility of 78.5% to be serious/critical ill. Most patients (88.8%) received antiviral treatments. Early antiviral treatment significantly shortened the viral RNA-negative conversion time. The delayed antiviral treatment was associated with critical patients.Conclusions: Younger age, lack of aging-related diseases and early hospitalization of all patients to conduct antiviral treatment and prevention of secondary epidemic were the important benign clinical and epidemiological outcomes-associated factors of COVID-19. In combating COVID-19, the active intervention strategies are crucial in low epidemic areas and the continuous monitoring of lymphocytes may be useful to sort patients reasonably in high epidemic areas.

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Section: Benign Outcomes-associated Factors In Treatmentssupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Benign Clinical and Epidemiological Outcomes-Associated Factors of COVID-19 from a Solved Epidemic with a Low Case Fatality Rate

Hu¹,

Liu²,

He³

et al. 2020

Preprint

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“…retrospective and prospective observational studies [12,15,31,32,[35][36][37]. There are also reports that eosinophil remains stable in severe COVID-19 patients [13,29,38,39].…”

Section: Persistent Eosinopenia After Admission Was Associated With Cmentioning

confidence: 98%

White blood cells and severe COVID-19: a Mendelian randomization study

Sun

Zhou

2020

Preprint

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Background: The pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly emerged to seriously threaten public health. We aimed to investigate whether white blood cell traits have potential causal effects on severe COVID-19 using Mendelian randomization (MR). Methods: To evaluate the causal associations between various white blood cell traits and severe COVID-19, we conducted a two-sample MR analysis with summary statistics from recent large genome-wide association studies. Results: Our MR results indicated potential causal associations of white blood cell count, myeloid white blood cell count, and granulocyte count with severe COVID-19, with odds ratios (OR) of 0.84 (95% CI: 0.72-0.98), 0.81 (95% CI: 0.70-0.94), and 0.84 (95% CI: 0.71-0.99), respectively. Increasing eosinophil percentage of white blood cells was associated with a higher risk of severe COVID-19 (OR: 1.22, 95% CI: 1.03-1.45). Conclusions: Our results suggest the potential causal effects of lower white blood cell count, lower myeloid white blood cell count, lower granulocyte count, and higher eosinophil percentage of white blood cells on an increased risk of severe COVID-19.

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“…[15][16][17][18][19][20][21][22][25][26][27][28]31 (Figure 3(a)) in 16 studies. [11][12][13][14]16,18,19,[21][22][23][25][26][27][28]31,34 (Figure 4(a)). [16][17][18][19][20][21][22][23][25][26][27]31 Figure 5) in 10 studies.…”

Section: Elevated Crp and Outcomementioning

confidence: 99%

C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis

Huang

Pranata

Lim

et al. 2020

Ther Adv Respir Dis

519

438

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Background: Patients critically ill with coronavirus disease-2019 (COVID-19) feature hyperinflammation, and the associated biomarkers may be beneficial for risk stratification. We aimed to investigate the association between several biomarkers, including serum C-reactive protein (CRP), procalcitonin (PCT), D-dimer, and serum ferritin, and COVID-19 severity. Methods: We performed a comprehensive systematic literature search through electronic databases. The outcome of interest for this study was the composite poor outcome, which comprises mortality, acute respiratory distress syndrome, need for care in an intensive care unit, and severe COVID-19. Results: A total of 5350 patients were pooled from 25 studies. Elevated CRP was associated with an increased composite poor outcome [risk ratio (RR) 1.84 (1.45, 2.33), p < 0.001; I2: 96%] and its severe COVID-19 (RR 1.41; I2: 93%) subgroup. A CRP ⩾10 mg/L has a 51% sensitivity, 88% specificity, likelihood ratio (LR) + of 4.1, LR- of 0.5, and an area under curve (AUC) of 0.84. An elevated PCT was associated with an increased composite poor outcome [RR 3.92 (2.42, 6.35), p < 0.001; I2: 85%] and its mortality (RR 6.26; I2: 96%) and severe COVID-19 (RR 3.93; I2: 63%) subgroups. A PCT ⩾0.5 ng/ml has an 88% sensitivity, 68% specificity, LR+ of 2.7, LR- of 0.2, and an AUC of 0.88. An elevated D-dimer was associated with an increased composite poor outcome [RR 2.93 (2.14, 4.01), p < 0.001; I2: 77%], including its mortality (RR 4.15; I2: 83%) and severe COVID-19 (RR 2.42; I2: 58%) subgroups. A D-dimer >0.5 mg/L has a 58% sensitivity, 69% specificity, LR+ of 1.8, LR- of 0.6, and an AUC of 0.69. Patients with a composite poor outcome had a higher serum ferritin with a standardized mean difference of 0.90 (0.64, 1.15), p < 0.0001; I2: 76%. Conclusion: This meta-analysis showed that an elevated serum CRP, PCT, D-dimer, and ferritin were associated with a poor outcome in COVID-19. The reviews of this paper are available via the supplemental material section.

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Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study

Cited by 128 publications

References 16 publications

Benign Clinical and Epidemiological Outcomes-Associated Factors of COVID-19 from a Solved Epidemic with a Low Case Fatality Rate

Benign Clinical and Epidemiological Outcomes-Associated Factors of COVID-19 from a Solved Epidemic with a Low Case Fatality Rate

White blood cells and severe COVID-19: a Mendelian randomization study

C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis

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