Potential Predictors for Disease Progression and Medication Evaluation of 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China (original) (raw)
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35 Pages Posted: 23 Mar 2020
Sheng Zhang
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Jingya Zhao
Shanghai Jiao Tong University (SJTU) - Department of Pulmonary and Critical Care Medicine
Zhixiong Wu
Fudan University - Department of Surgical Intensive Care Unit
You Shang
Huazhong University of Science and Technology - Department of Critical Care Medicine
Junhua Zheng
Shanghai Jiao Tong University (SJTU) - Department of Evidence-Based Medicine; Shanghai Jiao Tong University (SJTU) - Department of Urology
Mei Meng
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Jiao Liu
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Yanping Xu
Shanghai Jiao Tong University (SJTU) - Department of Respiratory and Critical Care Medicine
Guang Li
Wuhan University - Department of Critical Care Medicine
Mengmeng Shi
Shanghai Jiao Tong University (SJTU) - Department of Pulmonary and Critical Care Medicine
Mengyuan Diao
Zhejiang University - Department of Critical Care Medicine
Limin Chen
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Tao Wang
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Sisi Huang
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Wenzhe Li
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Qingyuan Yang
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Zhenliang Wen
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Lidi Zhang
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Xuan Dong
Huazhong University of Science and Technology - Department of Tuberculosis and Respiratory
Jie-ming Qu
Shanghai Jiao Tong University (SJTU) - Department of Respiratory and Critical Care Medicine
Dechang Chen
Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine
Abstract
Background: There are limited studies exploring the early warning indicators for mortality and disease progression, and the association between current treatment and outcome of NCIP.
Methods: In this retrospective, single-center study, we consecutively enrolled 262 hospitalized patients with confirmed NCIP at Wuhan Jinyintan Hospital from Dec 29, 2019 to Feb 17, 2020. Apart from epidemiological, demographic and radiological data, baseline and dynamic change of laboratory, clinical and therapeutic data were compared between patients with different prognosis.
Findings: Up to final date of follow-up, 86 (32·8%) patients died and 176 (67·2%) survived, of which 173 (66.0%) were discharged. Compared with survivors, non-survivors were elder (66.5 vs 49.9, p <0.0001), had more comorbidities and more abnormalities in follow-up laboratory tests, including persistent lower levels of lymphocytes, platelets and prealbumin, increasingly higher levels of myoglobin. Higher percentage of non-survivors received respiratory support. There was an increase in inflammatory markers before mechanical ventilation in a total of 79 patients suffering hypoxemia progression, including leukocytes, high-sensitivity-CRP, interleukin-6 and ferritin. More patients were given corticosteroids (61·6% vs 24·4%, p <0·0001) or lopinavir-ritonavir (20·9% vs 11·9%, p =0·082) in non-survivors, while the duration of the therapies showed non-significant difference.
Interpretation: Elder patients with more comorbidities and abnormalities in lymphocytes, platelets, prealbumin and myoglobin indicated poor prognosis of NCIP. Leukocytes, high-sensitivity-CRP, IL-6 and ferritin may predict the progression of disease. No evidence supported the effects of corticosteroids and lopinavir-ritonavir in NCIP treatment.
Funding Statement: This work was funded in part by a grant from Innovative research team of high-level local universities in Shanghai.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: The Ethics Commission of Jinyintan Hospital approved this study (KY-2020-03.01). Written informed consent was waived due to the rapid emergence of this infectious disease.
Keywords: novel coronavirus-infected pneumonia; laboratory; therapeutics; progression; outcome
Suggested Citation: Suggested Citation
Zhang, Sheng and Zhao, Jingya and Wu, Zhixiong and Shang, You and Zheng, Junhua and Meng, Mei and Liu, Jiao and Xu, Yanping and Li, Guang and Shi, Mengmeng and Diao, Mengyuan and Chen, Limin and Wang, Tao and Huang, Sisi and Li, Wenzhe and Yang, Qingyuan and Wen, Zhenliang and Zhang, Lidi and Dong, Xuan and Qu, Jie-ming and Chen, Dechang, Potential Predictors for Disease Progression and Medication Evaluation of 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China (3/7/2020). Available at SSRN: https://ssrn.com/abstract=3551399 or http://dx.doi.org/10.2139/ssrn.3551399