Analysis of inflammatory parameters and disease severity for 88 hospitalized COVID-19 patients in Wuhan, China

Abstract

Background and aim: The outbreak of coronavirus disease 2019 (COVID-19) is quickly turning into a pandemic. We aimed to further clarify the clinical characteristics and the relationship between these features and disease severity. Methods: In this retrospective single-center study, demographic, clinical and laboratory data were collected and analyzed among moderate, severe and critically ill group patients. Results: 88 hospitalization patients confirmed COVID-19 were enrolled in this study. The average age of the patients was 57.11 years (SD, ±15.39). Of these 88 patients, the median body mass index (BMI) was 24.03 (IQR, 21.64-26.61; range 15.05-32.39), the median duration from disease onset to hospital admission were 11 days (IQR, 6.50-14.50). 46.59% patients had one or more comorbidities, with hypertension being the most common (26.14%), followed by diabetes mellitus (12.50%) and coronary atherosclerotic heart disease (CAD) (7.95%). Common symptoms at onset of disease were fever (71.59%), cough (59.09%), dyspnea (38.64%) and fatigue (29.55%). 88 patients were divided into moderate (47 [53.41%]), severe (32 [36.36%]) and critically ill (9 [10.23%]) groups. Compared with severe and moderate patients, lymphocytopenia occurred in 85.71% critically ill patients, and serum IL-2R, IL-6, IL-8, TNF-α, LDH, and cTnI were also increased in 71.42%, 83.33%, 57.14%, 71.43%, 100% and 42.86% in critically ill patients. Through our analysis, the age, comorbidities, lymphocyte count, eosinophil count, ferritin, CRP, LDH, PT and inflammatory cytokines were statistically significant along with the disease severity. Conclusion: We found some clinical characteristic and inflammatory cytokines could reveal the severity of COVID-19 during the outbreak phage. Our research could assist the clinicians recognize severe and critically ill patients timely and focus on the expectant treatment for each patient.

Phenotypes and Subphenotypes of Patients With COVID-19

“…As recently published by Zeng et al, 22 the levels of proinflammatory cytokines, lactate dehydrogenase, and CRP are higher within 24 h of hospitalization and do not recover over the subsequent 10 days in those who are critically ill or die when compared with their counterparts with moderate or severe disease. Similar observations have been published elsewhere, 23,24 emphasizing that the individual patient immune phenotype heavily drives morbidity and mortality with COVID-19, and not just cellular damage directly inflicted by the virus. Our findings in this article provide a tool to put this immune response (as reflected by admission laboratory test results) into clinical context with other patient characteristics.…”

Clinical characteristics of asymptomatic and symptomatic COVID-19 patients in the Eastern Province of Saudi Arabia

“…In one study, ferritin levels were elevated in patients with severe disease COVID-19 or worse disease [ 38 ]. Similarly, D-dimer levels statistically significantly higher in severe disease compared to mild and moderate disease [ 38 , 39 ]. Thus, these studies explain the reason that there was no difference in the current study that did not include severe disease.…”

Carboxypeptidase B blocks ex vivo activation of the anaphylatoxin-neutrophil extracellular trap axis in neutrophils from COVID-19 patients

“…3 a), which implied that in addition to anaphylatoxins, there were other inducers of NETs in the plasma of severe patients. Many studies have reported an increase in IL-6, IL-1β, and CXCL-8 in severe patients with COVID-19 [ 41 – 43 ], which are also important factors that induce granulocyte activation and NET release. These pro-inflammatory cytokines may also contribute to the over-production of NETs in severe COVID-19 patients.…”