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

the role of CT to predict disease progression in patients with NCP. Previous study showed that the MuLBSTA score can early warn the mortality of viral pneumonia, which included lymphopenia and multilobe infiltration. 22 Our findings were consistent with theirs but more quantitatively in terms of imaging evaluation of lung involvement. Like SARS and MERS, some NCP patients progressed rapidly at about 10-14 days after onset likely dues to the cytokine storm in the body as evidenced by increased plasma proinflammatory cytokines. 11, 23 Our results further revealed the significant association between inflammatory markers and CT characteristics, especially for C-reactive protein and CT severity score, which indicated the potential value of CT to estimate pulmonary inflammation and lung damage. Furthermore, the predictive significance of NLR and CT severity score was confirmed only in nonimported patients outside Wuhan. Among the imported patients from Wuhan, the elder had higher risk to develop severe illness. However, the reason for this discrepancy between imported and nonimported patients remains to be elucidated.