Predictive factors of progression to severe COVID-19

• Published in: Open medicine (Warsaw, Poland) Vol. 15; no. 1; pp. 805 - 814
• Main Authors: Zhou, Yi-Hong, Li, Huan, Qin, Yuan-Yuan, Yan, Xiao-Feng, Lu, Yan-Qiu, Liu, Hong-Lan, Ye, Si-Kuan, Wan, Yan, Zhang, Lu, Harypursat, Vijay, Chen, Yaokai
• Format: Journal Article
• Language: English
• Published: Poland De Gruyter 01.01.2020; Walter de Gruyter GmbH
• Subjects: Coronavirus; Coronaviruses; COVID-19; Hospitalization; Hospitals; Infectious diseases; Laboratories; Medical diagnosis; Medical prognosis; Patients; predictive; progression; Public health; Risk factors; SARS-CoV-2; Sepsis; Severe acute respiratory syndrome coronavirus 2; COVID-19; predictive; progression; SARS-CoV-2; Coronavirus
• ISSN: 2391-5463; 2391-5463
• DOI: 10.1515/med-2020-0184

Early diagnosis and treatment are crucial for the survival of severe Coronavirus Disease 2019 (COVID-19) patients, but data with regard to risk factors for disease progression from milder COVID-19 to severe COVID-19 remain scarce. We conducted a retrospective analysis on 116 patients. Three factors were observed to be independently associated with progression to severe COVID-19 during 14 days after admission: (a) age 65 years or older (hazard ratio [HR] = 8.456; 95% CI: 2.706-26.426); (b) creatine kinase (CK) ≥ 180 U/L (HR = 3.667; 95% CI: 1.253-10.733); and (c) CD4+ T-cell counts <300 cells/µL (HR = 4.695; 95% CI: 1.483-14.856). The difference in rates of severe COVID-19 development was found to be statistically significant between patients aged 65 years or older (46.2%) and those younger than 65 years (90.2%), between patients with CK ≥ 180 U/L (55.6%) and those with CK < 180 U/L (91.5%), and between patients with CD4+ T-cell counts <300 cells/µL (53.8%) and those with CD4+ cell counts ≥300 cells/µL (83.2%). Age ≥ 65 years, CK ≥ 180 U/L, and CD4+ T-cell counts <300 cells/µL at admission were risk factors independently associated with disease progression to severe COVID-19 during 14 days after admission and are therefore potential markers for disease progression in patients with milder COVID-19.