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A cohort study of 223 patients explores the clinical risk factors for the severity diagnosis of COVID-19
dc.contributor.author | Huang, Yongshent et al. | |
dc.date.accessioned | 2020-06-29T19:08:02Z | |
dc.date.available | 2020-06-29T19:08:02Z | |
dc.date.issued | 2020-04-24 | |
dc.identifier.uri | https://doi.org/10.1101/2020.04.18.20070656 | en_US |
dc.identifier.uri | https://hdl.handle.net/20.500.12663/1851 | |
dc.description.abstract | oronavirus Disease 2019 (COVID-19) has recently become a public emergency and a worldwide pandemic. The clinical symptoms of severe and non-severe patients vary, and the case-fatality rate (CFR) in severe COVID-19 patients is very high. However, the information on the risk factors associated with the severity of COVID-19 and of their prognostic potential is limited. METHODS: In this retrospective study, the clinical characteristics, laboratory findings, treatment and outcome data were collected and analyzed from 223 COVID-19 patients stratified into 125 non-severe patients and 98 severe patients. In addition, a pooled large-scale meta-analysis of 1646 cases was performed. RESULTS: We found that the age, gender and comorbidities are the common risk factors associated with the severity of COVID-19. For the diagnosis markers, we found that the levels of D-dimer, C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT) were significantly higher in severe group compared with the non-severe group on admission (D-Dimer: 87.3% vs. 35.3%, P<0.001; CRP, 65.1% vs. 13.5%, P<0.001; LDH: 83.9% vs. 22.2%, P<0.001; PCT: 35.1% vs. 2.2%, P<0.001), while the levels of aspartate aminotransferase (ASP) and creatinine kinase (CK) were only mildly increased. We also made a large scale meta-analysis of 1646 cases combined with 4 related literatures, and further confirmed the relationship between the COVID-19 severity and these risk factors. Moreover, we tracked dynamic changes during the process of COVID-19, and found CRP, D-dimer, LDH, PCT kept in high levels in severe patient. Among all these markers, D-dimer increased remarkably in severe patients and mostly related with the case-fatality rate (CFR). We found adjuvant antithrombotic treatment in some severe patients achieved good therapeutic effect in the cohort. CONCLUSIONS: The diagnosis markers CRP, D-dimer, LDH and PCT are associated with severity of COVID-19. Among these markers, D-dimer is sensitive for both severity and CFR of COVID-19. Treatment with heparin or other anticoagulants may be beneficial for COVID-19 patients. | en_US |
dc.language | English | en_US |
dc.subject | COVID-19 | en_US |
dc.subject | Coronavirus | en_US |
dc.subject | Cohort Studies | en_US |
dc.subject | Risk Factors | en_US |
dc.subject | Emergencies | en_US |
dc.subject | Pandemics | en_US |
dc.subject | Mortality | en_US |
dc.subject | Retrospective Studies | en_US |
dc.subject | Meta-Analysis | en_US |
dc.subject | Polymerase Chain Reaction | en_US |
dc.title | A cohort study of 223 patients explores the clinical risk factors for the severity diagnosis of COVID-19 | en_US |
eihealth.country | Global (WHO/OMS) | en_US |
eihealth.category | Clinical characterization and management | en_US |
eihealth.type | Published Article | en_US |
eihealth.maincategory | Protect Health Care Workers / Proteger la Salud de los Trabajadores | en_US |
dc.relation.ispartofjournal | medRxiv | en_US |
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