Laboratory Predictors of COVID-19 Pneumonia in Patients with Mild to Moderate Symptoms

Li, Jiaxia; Wan, Li; Feng, Yuan; Zuo, Huilin; Zhao, Qian; Ren, Jiecheng; Zhang, Xiaochu; Xia, Mingwu

OBJECTIVE: This research aims to develop a laboratory model that can accurately distinguish pneumonia from nonpneumonia in patients with COVID-19 and to identify potential protective factors against lung infection. METHODS: We recruited 50 patients diagnosed with COVID-19 infection with or without pneumonia. We selected candidate predictors through group comparison and punitive least absolute shrinkage and selection operator (LASSO) analysis. A stepwise logistic regression model was used to distinguish patients with and without pneumonia. Finally, we used a decision-tree method and randomly selected 50% of the patients 1000 times from the same specimen to verify the effectiveness of the model. RESULTS: We found that the percentage of eosinophils, a high–fluorescence-reticulocyte ratio, and creatinine had better discriminatory power than other factors. Age and underlying diseases were not significant for discrimination. The model correctly discriminated 77.1% of patients. In the final validation step, we observed that the model had an overall predictive rate of 81.3%. CONCLUSION: We developed a laboratory model for COVID-19 pneumonia in patients with mild to moderate symptoms. In the clinical setting, the model will be able to predict and differentiate pneumonia vs nonpneumonia before any lung computed tomography findings. In addition, the percentage of eosinophils, a high–fluorescence-reticulocyte ratio, and creatinine were considered protective factors against lung infection in patients without pneumonia.