Short-term outcomes of COVID-19 and risk factors for progression

Li, Long; Zeng, Xiansheng; Zhang, Xu; Xiao, Wei; Guo, Ensong; Zhan, Wenzhi; Yang, Xiaohang; Li, Chunyan; Wu, Caiyun; Xu, Tingting; Zhan, Cheng; Chen, Yuehan; Jiang, Mei; Zhong, Nanshan; Lai, Kefang

doi:10.1183/13993003.00990-2020

Cited by 61 publications

(61 citation statements)

References 5 publications

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“…In addition, the females received a larger dose/kg than males since the same bolus was delivered to all animals in spite of different weights (average weight of 1419 g for males and of 740 g for females at D0). A lower susceptibility has been suggested in females, at least in humans (23)(24)(25)(26), and this may explain why no difference in the severity of the disease was measurable between sexes in our study. Weight dependent infection doses in future studies may highlight sex differences in the severity of experimental outcomes.…”

Section: Discussionsupporting

confidence: 53%

Hamster and ferret experimental infection with intranasal low dose of a single strain of SARS-CoV-2

Monchâtre-Leroy

Lesellier²,

Wasniewski

et al. 2020

Preprint

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Understanding the pathogenesis of the SARS-CoV-2 infection is key to develop preventive and therapeutic strategies against COVID-19, in the case of severe illness but also when the disease is mild. The use of appropriate experimental animal models remains central in the in-vivo exploration of the physiopathology of infection and antiviral strategies. This study describes SARS-CoV-2 intra-nasal infection in ferrets and hamsters with low doses of low-passage SARS-CoV-2 clinical French isolate UCN19, describing infection levels, excretion, immune responses and pathological patterns in both animal species. Individual infection with 103 pfu SARS-CoV-2 induced a more severe disease in hamsters than in ferrets. Viral RNA was detected in the lungs of hamsters but not of ferrets and in the brain (olfactive and/or spinal bulbs) of both species. Overall, the clinical disease remained mild, with serological responses detected from 7 days and 10 days post inoculation in hamsters and ferrets respectively. Virus became undetectable and pathology resolved within 14 days. The kinetics and levels of infection can be used in ferrets and hamsters as experimental models for understanding the pathogenicity of SARS-CoV-2, and testing the protective effect of drugs.

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Section: Discussionsupporting

confidence: 53%

Hamster and ferret experimental infection with intranasal low dose of a single strain of SARS-CoV-2

Monchâtre-Leroy

Lesellier²,

Wasniewski

et al. 2020

Preprint

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“…For COVID-19 patients, NLR has been shown to be an independent risk factor for severe disease [39][40][41]. Fifty (75.8%) patients with disease progression during hospitalization had a NLR !2.973 [42], which may indicate COVID-19 infection severity [43]. Binary logistic analysis identified elevated NLR (hazard risk (HR): 2.46, 95% confidence interval (CI): 1.98-4.57) as an independent factor for poor COVID-19 clinical outcome [44], which was confirmed by a meta-analysis which reported that NLR values were significantly increased in severe COVID-19 patients [45].…”

Section: Hematologic Biomarkersmentioning

confidence: 79%

Biomarkers associated with COVID-19 disease progression

Ponti

Maccaferri

Ruini

et al. 2020

Critical Reviews in Clinical Laboratory Sciences

765

678

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The coronavirus disease 2019 (COVID-19) pandemic is a scientific, medical, and social challenge. The complexity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is centered on the unpredictable clinical course of the disease that can rapidly develop, causing severe and deadly complications. The identification of effective laboratory biomarkers able to classify patients based on their risk is imperative in being able to guarantee prompt treatment. The analysis of recently published studies highlights the role of systemic vasculitis and cytokine mediated coagulation disorders as the principal actors of multi organ failure in patients with severe COVID-19 complications. The following biomarkers have been identified: hematological (lymphocyte count, neutrophil count, neutrophil-lymphocyte ratio (NLR)), inflammatory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)), immunological (interleukin (IL)-6 and biochemical (D-dimer, troponin, creatine kinase (CK), aspartate aminotransferase (AST)), especially those related to coagulation cascades in disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). New laboratory biomarkers could be identified through the accurate analysis of multicentric case series; in particular, homocysteine and angiotensin II could play a significant role.

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“…Patients with LYM% <5% were critical, had a high mortality rate, and required intensive care. The NLR was higher for identifying patients with severe pneumonia, when compared to that for identifying those who have died, suggesting that a higher NLR might predict the progression during hospitalisation [25]. In the study conducted by Ding et al [26], the NLR was significantly higher in severe patients, when compared to non-severe patients, at all time points after hospital admission, and the NLR was positively correlated with hospitalisation time from day 5 after admission.…”

Section: Discussionmentioning

confidence: 92%

“…All patients (n = 131) Survivors (n = 119, 90.2%) Non-survivors (n = 12, 9.8%) P-value a important contributor to respiratory viral infections [28], while cytokines, such as IL-10, IL-6 and tumour necrosis factor-α, might activate the neutrophils and damage the lymphocytes [25,29]. Thus, the NLR may reflect the level of severity of COVID-19.…”

Section: Demographic Characteristicsmentioning

confidence: 99%

Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre

Wang

Shang³

et al. 2020

Epidemiol. Infect.

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The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a public health emergency of international concern. The current study aims to explore whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with the development of death in patients with COVID-19. A total of 131 patients diagnosed with COVID-19 from 13 February 2020 to 14 March 2020 in a hospital in Wuhan designated for treating COVID-19 were enrolled in the current study. These 131 patients had a median age of 64 years old (interquartile range: 56–71 years old). Furthermore, among these patients, 111 (91.8%) patients were discharged and 12 (9.2%) patients died in the hospital. The pooled analysis revealed that the NLR at admission was significantly elevated for non-survivors, when compared to survivors (P < 0.001). The NLR of 3.338 was associated with all-cause mortality, with a sensitivity of 100.0% and a specificity of 84.0% (area under the curve (AUC): 0.963, 95% confidence interval (CI) 0.911–1.000; P < 0.001). In view of the small number of deaths (n = 12) in the current study, NLR of 2.306 might have potential value for helping clinicians to identify patients with severe COVID-19, with a sensitivity of 100.0% and a specificity of 56.7% (AUC: 0.729, 95% CI 0.563–0.892; P = 0.063). The NLR was significantly associated with the development of death in patients with COVID-19. Hence, NLR is a useful biomarker to predict the all-cause mortality of COVID-19.

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Short-term outcomes of COVID-19 and risk factors for progression

Cited by 61 publications

References 5 publications

Hamster and ferret experimental infection with intranasal low dose of a single strain of SARS-CoV-2

Hamster and ferret experimental infection with intranasal low dose of a single strain of SARS-CoV-2

Biomarkers associated with COVID-19 disease progression

Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre

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