The timeline and risk factors of clinical progression of COVID-19 in Shenzhen, China

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background The novel coronavirus disease 2019(COVID-19) broke out globally. Early prediction of the clinical progression was essential but still unclear. We aimed to evaluate the timeline of COVID-19 development and analyze risk factors of disease progression.Methods In this retrospective study, we included 333 patients with laboratory-confirmed COVID-19 infection hospitalized in the Third People's Hospital of Shenzhen from 10 January to 10 February 2020. Epidemiological feature, clinical records, laboratory and radiology manifestations were collected and analyzed. 323 patients with mild-moderate symptoms on admission were observed to determine whether they exacerbated to severe-critically ill conditions (progressive group) or not (stable group). We used logistic regression to identify the risk factors associated with clinical progression.Results Of all the 333 patients, 70(21.0%) patients progressed into severe-critically ill conditions during hospitalization and assigned to the progressive group, 253(76.0%) patients belonged to the stable group, another 10 patients were severe before admission. we found that the clinical features of aged over 40 (3.80[1.72, 8.52]), males (2.21[1.20, 4.07]), with comorbidities (1.78[1.13, 2.81]) certain exposure history (0.38[0.20, 0.71]), abnormal radiology manifestations (3.56[1.13, 11.40]), low level of T lymphocytes (0.99[0.997, 0.999]), high level of NLR (0.99[0.97, 1.01]), IL-6 (1.05[1.03, 1.07]) and CRP (1.67[1.12, 2.47]) were the risk factors of disease progression by logistic regression.Conclusions the potential risk factors of males, older age, with comorbidities, low T lymphocyte level and high level of NLR, CRP, IL-6 can help to predict clinical progression of COVID-19 at an early stage.</jats:p>

Cardiovascular disease and severe hypoxemia associated with higher rates of non-invasive respiratory support failure in COVID-19

“…Closer examination of non-invasive respiratory support use patterns revealed that the highest probabilities of requiring HFNC or NIPPV occurred relatively early in the hospital course, consistent with other studies reporting deteriorating respiratory status and development of ARDS soon after admission (4, 5, 32). Notably, we found that the median time to treatment failure was within two days after initiation of HFNC or NIPPV, highlighting that the immediate period after initiation of non-invasive respiratory support represents a crucial window for clinical deterioration and progression of disease.…”

Immune Response to SARS-CoV-2 Infection in Obesity and T2D: Literature Review

“…Importantly, patients hospitalized with underlying conditions presented worse lymphocytopenia than those who did not report comorbidities [ 178 , 185 , 186 , 187 , 189 ]. Based on this information, the majority of the researchers have proposed that lymphocytopenia could potentially be used as an indicator of COVID-19 severity [ 190 , 191 , 192 ]. Conversely, to what is reported about the quantitative aspects of T-cell populations during the COVID-19 course, an aspect in which there is a pronounced lack of understanding is whether T-cell response might positively or negatively contribute towards the severity of this disease [ 193 ].…”

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