[Predictors of Severe COVID-19 Pneumonia]

ABSTRACT

In patients with COVID-19, age over 50 years is also considered as an indication for antiviral drug therapy, in addition to hypoxemia. At this time, it still remains unclear as to which clinical markers can be considered as being predictive of severe COVID-19 pneumonia with hypoxemia. We categorized 49 patients with COVID-19 pneumonia into the following 4 groups by the clinical manifestations stage A no symptoms, and no viral pneumonia on chest computed tomography (CT);stage B symptom (s) present, but no viral pneumonia on CT;stage C viral pneumonia on CT, but no hypoxemia;stage D viral pneumonia on CT, with hypoxemia. The clinical background characteristics that were correlated with the disease severity were the patient age, presence/absence of complications, smoking history, and presence/absence of fever and diarrhea, but multivariate analysis identified only smoking history as being significantly predictive of stage D disease. The lymphocyte count, serum CRP level, serum ferritin level and incidence of consolidation on CT were significantly different between patients with stage C and stage D disease. Therefore, we propose five predictors of severe COVID-19 pneumonia, namely, smoking history, lymphocyte count 1,200 μL, serum ferritin 400 ng/mL, serum CRP 2.5 mg/dL, and presence of consolidation on CT. The interval (in days) from the onset of symptom (s) to the first negative result of PCR for SARS-CoV2 was well correlated with the number of these risk factors in each patient (p�E�E.0001�E�E