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Prognostic Factors for COVID-19 Pneumonia Progression to Severe Symptoms Based on Earlier Clinical Features: A Retrospective Analysis.
Huang, Huang; Cai, Shuijiang; Li, Yueping; Li, Youxia; Fan, Yinqiang; Li, Linghua; Lei, Chunliang; Tang, Xiaoping; Hu, Fengyu; Li, Feng; Deng, Xilong.
  • Huang H; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Cai S; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Li Y; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Li Y; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Fan Y; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Li L; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Lei C; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Tang X; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Hu F; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Li F; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Deng X; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Front Med (Lausanne) ; 7: 557453, 2020.
Article in English | MEDLINE | ID: covidwho-890338
ABSTRACT
Approximately 15-20% of COVID-19 patients will develop severe pneumonia, and about 10% of these will die if not properly managed. Earlier discrimination of potentially severe patients basing on routine clinical and laboratory changes and commencement of prophylactical management will not only save lives but also mitigate the otherwise overwhelming healthcare burden. In this retrospective investigation, the clinical and laboratory features were collected from 125 COVID-19 patients who were classified into mild (93 cases) or severe (32 cases) groups according to their clinical outcomes after 3-7 days post-admission. The subsequent analysis with single-factor and multivariate logistic regression methods indicated that 17 factors on admission differed significantly between mild and severe groups but that only comorbidity with underlying diseases, increased respiratory rate (>24/min), elevated C-reactive protein (CRP >10 mg/L), and lactate dehydrogenase (LDH >250 U/L) were independently associated with the later disease development. Finally, we evaluated their prognostic values with receiver operating characteristic curve (ROC) analysis and found that the above four factors could not confidently predict the occurrence of severe pneumonia individually, though a combination of fast respiratory rate and elevated LDH significantly increased the predictive confidence (AUC = 0.944, sensitivity = 0.941, and specificity = 0.902). A combination consisting of three or four factors could further increase the prognostic value. Additionally, measurable serum viral RNA post-admission independently predicted the severe illness occurrence. In conclusion, a combination of general clinical characteristics and laboratory tests could provide a highly confident prognostic value for identifying potentially severe COVID-19 pneumonia patients.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Front Med (Lausanne) Year: 2020 Document Type: Article Affiliation country: Fmed.2020.557453

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Front Med (Lausanne) Year: 2020 Document Type: Article Affiliation country: Fmed.2020.557453