CLINICAL PHENOTYPES OF COVID-19 PNEUMONIA: different phases of viral process or really different states?

ABSTRACT

During COVID-19 pandemic cases of severe COVID-19 demonstrate heterogeneity among group of patients (pts) some pts are severe because of more expressed respiratory failure, other - because of inflammation, another - because of cardiac and thrombotic complications. Does it different phases of viral process or really different states? Aim: to estimate most valuable categories of pts with severe COVID-19 by separating of clinical phenotypes during cluster analysis. Material(s) and Method(s) 97 pts, who were hospitalized with severe COVID-19 pneumonia (male - 43 (44,3%), age - 58,8+/-1,4yrs, SpO2 - 91,1+/-0,7%). Measurements clinical examination, SpO2, chest CT, laboratory CBC, Creactive protein (CRP), D-dimer, Creatine Phosphokinase-MB (CPK-MB), Troponin I, ferritin. Result(s) nevertheless that all pts were severe, cluster analysis shown two heterogeneous groups 1) with lower saturation and higher thromboinflammation, with lower lymphocytes;2) with higher saturation and lower thromboinflammation, with normal lymphocytes (p<0,002 for all) (Fig. 1). Conclusion(s) 1. Expression of respiratory failure in pts with severe COVID-19 is not an isolated parameter;it is connected with severity of thromboinflammation and cardiac lesion. 2. The estimation of CRP, D-dimer, CPK-MB, troponin I, ferritin can be use as predictors of severity in COVID-19 pneumonia, but the first and screening pathogenetical link is lymphopenia. (Figure Presented).