Int J Med Sci 2021; 18(4):921-928. doi:10.7150/ijms.51205 This issue Cite

Research Paper

Risk factors for illness severity in patients with COVID-19 pneumonia: a prospective cohort study

Nannan Zhang1, Hairong Zhang2, Yanhua Tang1, Hao Zhang3, Aiying Ma4, Fang Xu1, Yu Sun5✉, Luning Jiang1✉, Fangzhen Shan6,7✉

1. Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China.
2. Department of surgery, Jining Infectious Disease Hospital, Jining City 272000, Shandong, China.
3. Department of hematology, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China.
4. Department of Intensive care unit II, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China.
5. Department of infectious disease, Jining Infectious Disease Hospital, Jining City 272000, Shandong, China.
6. Medical Research Center, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China.
7. Hefei National Laboratory for Physical Science at Microscale and School of Life Science, University of Science and Technology of China, Hefei 230026, Anhui, China.

Citation:
Zhang N, Zhang H, Tang Y, Zhang H, Ma A, Xu F, Sun Y, Jiang L, Shan F. Risk factors for illness severity in patients with COVID-19 pneumonia: a prospective cohort study. Int J Med Sci 2021; 18(4):921-928. doi:10.7150/ijms.51205. https://www.medsci.org/v18p0921.htm
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Abstract

Background: Although COVID-19 pneumonia is spreading internationally, knowledge regarding the factors associated with the illness severity of patients remains limited. We aimed to identify the factors associated with the disease severity of patients with COVID-19 pneumonia induced by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods: We prospectively enrolled a single-center case series of adult patients with COVID-19 admitted to the Infectious Disease Hospital of Jining, Jining City, Shandong Province, China, from January 24 to March 1, 2020. Demographics, clinical characteristics, and laboratory findings were compared to investigate the risk factors related with the disease severity of COVID-19 pneumonia patients.

Results: We included a total of 78 patients with COVID-19 pneumonia, of whom 6 had the severe type. As compared to a moderately ill cohort, our analysis showed that shortness of breath, fatigue, longer days from illness onset to diagnosis confirmed, neutrophil percentages > 70%, neutrophil counts > 6.3 × 109/L, lymphocyte percentages < 20%, lymphocyte counts < 1.0 × 109/L, platelet < 100 × 109/L, C-reactive protein (CRP) > 10 mg/L, neutrophil to platelet ratio (NPR) > 2.3, neutrophil to lymphocyte ratio (NLR) > 3.9, aspartate aminotransferase (AST) > 40 U/L, albumin < 40 g/L, lactate dehydrogenase (LDH) > 245 U/L, and glucose > 6.1 mmol/L were predictors of disease severity in COVID-19 pneumonia. In the sex-, age-, and comorbid illness-matched case-control study, neutrophil percentages > 70%, neutrophil counts > 6.3 × 109/L, lymphocyte percentages < 20%, NPR > 2.3, NLR > 3.9, albumin < 40 g/L, and LDH > 245 U/L remained associated with the early detection and identification of severe patients.

Conclusion: We demonstrated that neutrophil percentages > 70%, neutrophil counts > 6.3 × 109/L, lymphocyte percentages < 20%, NPR > 2.3, NLR > 3.9, albumin < 40 g/L, and LDH > 245 U/L might predict the severity of illness in patients with COVID-19 pneumonia.

Keywords: SARS-CoV-2, COVID-19, severity, risk factor, prospective studies


Citation styles

APA
Zhang, N., Zhang, H., Tang, Y., Zhang, H., Ma, A., Xu, F., Sun, Y., Jiang, L., Shan, F. (2021). Risk factors for illness severity in patients with COVID-19 pneumonia: a prospective cohort study. International Journal of Medical Sciences, 18(4), 921-928. https://doi.org/10.7150/ijms.51205.

ACS
Zhang, N.; Zhang, H.; Tang, Y.; Zhang, H.; Ma, A.; Xu, F.; Sun, Y.; Jiang, L.; Shan, F. Risk factors for illness severity in patients with COVID-19 pneumonia: a prospective cohort study. Int. J. Med. Sci. 2021, 18 (4), 921-928. DOI: 10.7150/ijms.51205.

NLM
Zhang N, Zhang H, Tang Y, Zhang H, Ma A, Xu F, Sun Y, Jiang L, Shan F. Risk factors for illness severity in patients with COVID-19 pneumonia: a prospective cohort study. Int J Med Sci 2021; 18(4):921-928. doi:10.7150/ijms.51205. https://www.medsci.org/v18p0921.htm

CSE
Zhang N, Zhang H, Tang Y, Zhang H, Ma A, Xu F, Sun Y, Jiang L, Shan F. 2021. Risk factors for illness severity in patients with COVID-19 pneumonia: a prospective cohort study. Int J Med Sci. 18(4):921-928.

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