ABSTRACT
To evaluate the predictive effect of T-lymphoid subsets on the conversion of common covid-19 to severe. The laboratory data were collected retrospectively from common covid-19 patients in the First People's Hospital of Zaoyang, Hubei Province, China and the Third People's Hospital of Kunming, Yunnan Province, China, between January 20, 2020 and March 15, 2020 and divided into training set and validation set. Univariate and multivariate logistic regression was performed to investigate the risk factors for the conversion of common covid-19 to severe in the training set, the prediction model was established and verified externally in the validation set. 60 (14.71%) of 408 patients with common covid-19 became severe in 6-10 days after diagnosis. Univariate and multiple logistic regression analysis revealed that lactate (P = 0.042, OR = 1097.983, 95% CI 1.303, 924,798.262) and CD8+ T cells (P = 0.010, OR = 0.903, 95% CI 0.835, 0.975) were independent risk factors for general type patients to turn to severe type. The area under ROC curve of lactate and CD8+ T cells was 0.754 (0.581, 0.928) and 0.842 (0.713, 0.970), respectively. The actual observation value was highly consistent with the prediction model value in curve fitting. The established prediction model was verified in 78 COVID-19 patients in the verification set, the area under the ROC curve was 0.906 (0.861, 0.981), and the calibration curve was consistent. CD8+ T cells, as an independent risk factor, could predict the transition from common covid-19 to severe.
Subject(s)
CD8-Positive T-Lymphocytes/virology , COVID-19/blood , Disease Progression , Adrenal Cortex Hormones/administration & dosage , Adult , Algorithms , COVID-19/pathology , China , Female , Humans , Hypoxia/metabolism , Lopinavir/administration & dosage , Male , Methylprednisolone/administration & dosage , Middle Aged , Multivariate Analysis , Oxygen/chemistry , Predictive Value of Tests , Prognosis , ROC Curve , Real-Time Polymerase Chain Reaction , Regression Analysis , Retrospective Studies , Risk Factors , Ritonavir/administration & dosageABSTRACT
In coronavirus disease 2019 (COVID-19) patients, interleukin (IL)-6 is one of the leading factors causing death through cytokine release syndrome. Hence, identification of IL-6 downstream from clinical patients' transcriptome is very valid for analyses of its mechanism. However, clinical study is conditional and time consuming to collect optional size of samples, as patients have the clinical heterogeneity. A possible solution is to deeply mine the relative existing data. Several transcriptome-based studies on other diseases or treatments have revealed different genes to be regulated by IL-6. Through our meta-analysis of these transcriptome datasets, 352 genes were suggested to be regulated by IL-6 in different biological conditions, some of which were related to virus infection and cardiovascular disease. Among them, 232 genes were not identified by current transcriptome studies from clinical research. ICAM1 and PFKFB3 were the most significantly upregulated genes in our meta-analysis and could be employed as biomarkers in patients with severe COVID-19. In general, a meta-analysis of transcriptome datasets could be an alternative way to analyze the immune response and complications of patients suffering from severe COVID-19 and other emergency diseases.
ABSTRACT
To analyze the epidemiological characteristics and early clinical characteristics of patients with new coronavirus (2019-nCoV) infection in Kunming, and to provide evidence for clinical diagnosis and treatment. The epidemiological history, clinical symptoms, and laboratory test data of 41 of 2019-nCoV confirmed patients admitted to the isolation ward of The third People's Hospital of Kunming from January 23 to February 10, 2020 were retrospectively analyzed. The vast majority of 41 2019-nCoV confirmed patients were imported cases, with incubation periods ranging from 2 to 20 days;severe and critically ill patients were Severe and critically ill patients were older, had higher BMI, similar clinical symptoms, and lymphocytes than patients with mild and general type Lower counts, earlier changes in blood gas, higher erythrocyte sedimentation, lower CA and FE, and more significant decreases in CD4 and CD8 counts. The changes of lymphocyte count, blood gas, ESR, CA and FE and T lymphocyte subsets will appear earlier in the week before the disease is aggravated, which has a certain early warning effect on the severity of the disease.