Clinical Characteristics of Patients With Progressive and Non-progressive Coronavirus Disease 2019: Evidence From 365 Hospitalised Patients in Honghu and Nanchang, China

Zhang, Yanpei; Xiao, Lu-shan; Li, Pu; Zhu, Hongbo; Hu, Chenyi; Zhang, Wen-Feng; Sun, Qing-can; Shen, Meng-ying; Liu, Shan-shan; Zhang, Wan-li; Zeng, Han-yi; Gong, Mengchun; Liu, Li; He, Yu-Lin; Zhu, Hong

Background: Coronavirus disease (COVID-19) has swept around the globe and led to a worldwide catastrophe. Studies examining the disease progression of patients with non-severe disease on admission are scarce but of profound importance in the early identification of patients at a high risk of deterioration. Objectives: To elucidate the differences in clinical characteristics between patients with progressive and non-progressive COVID-19 and to determine the risk factors for disease progression. Study design: Clinical data of 365 patients with non-severe COVID-19 from 1 January 2020 to 18 March 2020 were retrospectively collected. Patients were stratified into progressive and non-progressive disease groups. Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for disease progression. Results: Compared with patients with non-progressive disease, those who progressed to severe COVID-19 were older and had significantly decreased lymphocyte and eosinophil counts; increased neutrophil and platelet counts; lower albumin levels; higher levels of lactate dehydrogenase, C-reactive protein (CRP), creatinine, creatinine kinase, and urea nitrogen; and longer prothrombin times. Hypertension, fever, fatigue, anorexia, bacterial coinfection, bilateral patchy shadowing, antibiotic and corticosteroid administration, and oxygen support had a significantly higher incidence among patients with progressive disease. A significantly longer duration of hospital stay was also observed in patients with progressive disease. Bilateral patchy shadowing (OR = 4.82, 95% CI: 1.33–17.50; P = 0.017) and elevated levels of creatinine (OR =6.24, 95% CI: 1.42–27.40; P = 0.015), and CRP (OR = 7.28, 95% CI: 2.56–20.74; P < 0.001) were independent predictors for disease progression. Conclusion: The clinical characteristics of patients with progressive and non-progressive COVID-19 were significantly different. Bilateral patchy shadowing and increased levels of creatinine, and CRP were independent predictors of disease progression.