Epidemiological and clinical features of 291 cases with coronavirus disease 2019 in areas adjacent to Hubei, China: a double-center observational study

Xu Chen; Fang Zheng; Yanhua Qing; Shuizi Ding; Danhui Yang; Cheng Lei; Zhilan Yin; Xianglin Zhou; Dixuan Jiang; Qi Zuo; Jun He; Jianlei Lv; Ping Chen; Yan Chen; Hong Peng; Honghui Li; Yuanlin Xie; Jiyang Liu; Zhiguo Zhou; Hong Luo

Inconsistent with the other research 10 , elevated D-dimer was observed in majority of patients (83.5%) in our study, and its level was significantly higher in severe/critical group. Consistent with the research of Guan, 13 Myocardial damage and elevated liver enzyme were not common and mainly happened in severe/critical group. Besides, Obvious disorder of renal function and electrolyte were relatively rare in our patients. 77.6% patients with available coagulation function test result had elevated fibrinogen on admission, and the proportion in severe/critical group was even higher, which have not been observed in other studies. In the early stages of SARS patients, researchers also found an increase in fibrinogen. 18 Previous studies had shown that SARS-CoV 3a protein can up regulate the expression of fibrinogen in lung epithelial cells. 19 We speculate in the lung inflammation caused by SARS-CoV-2 or the secondary systemic inflammation, the activated body stress system may lead to the increase of fibrinogen. Another interesting phenomenon was that considerable proportion of patients had positive results in Mycoplasma pneumonia or Chlamydia pneumonia antibody tests, which indicate Mycoplasma pneumonia or Chlamydia pneumonia co-infection, which was higher than other research.