Early Prediction of Disease Progression in 2019 Novel Coronavirus Pneumonia Patients Outside Wuhan with CT and Clinical Characteristics

Zhichao Feng; Qizhi Yu; Shanhu Yao; Lei Luo; Junhong Duan; Zhimin Yan; Min Yang; Hongpei Tan; Mengtian Ma; Ting Li; Dali Yi; Ze Mi; Huafei Zhao; Yi Jiang; Zhenhu He; Huiling Li; Wei Nie; Yin Liu; Jing Zhao; Muqing Luo; Xuanhui Liu; Pengfei Rong; Wei Wang

A total of 224 patients were identified according to the inclusion criteria, of which 83 patients were excluded for having: 1) observation period from admission less than 14 days (n = 60); 2) negative CT findings or severe NCP on admission (n = 16); 3) age younger than 18 years old (n = 7). Finally, a cohort of 141 patients were included in our study (Figure 1 ). The baseline demographic, epidemiological, and laboratory characteristics of included 141 patients are presented in Table 1 . Among them, 76 (53.9%) patients who had recently been to Wuhan were imported and 72 (51.1%) were male, with a median age of 44 years and a median period symptom onset to admission of 4 days. 52 patients of them had discharged at enrollment. During the hospitalization, 15 cases progressed to severe NCP (progressive group) and the remaining patients did not (stable group). Compare with stable group, patients in progressive group were significantly older (P = 0.001), but the male gender and imported proportions were not shown statistical difference. Patients who progressed to severe NCP were more likely to have underlying hypertension (P = 0.004), but did not otherwise have significant differences in other co-morbidities including diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular disease, cerebrovascular disease and chronic hepatitis B infection. The main symptoms between the two groups were not statistically different, while slightly more patients manifested digestive symptoms in progressive group, such as anorexia and diarrhea (P = 0.088 and 0.065, respectively). Patients in the progressive group had lower baseline lymphocyte count, higher neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (all P < 0.01).