Clinical characteristics and co-infections of 354 hospitalized patients with COVID-19 in Wuhan, China: a retrospective cohort study

Abstract

From December 2019, a novel coronavirus, SARS-CoV-2, caused an outbreak of pneumonia in Wuhan city and rapidly spread throughout China and globally. However, the clinical characteristics and co-infection with other respiratory pathogens of patients with COVID-19 and the factors associated with severity of COVID-19 are still limited. In this retrospective cohort study, we included 354 inpatients with COVID-19 admitted to Renmin Hospital of Wuhan University from February 4, 2020 to February 28, 2020. We found levels of interleukin-6, interleukin-10, C-reactive protein, D-dimer, white blood cell count and neutrophil count were clearly elevated in males and critical cases compared with females and severe and mild cases, respectively. However, lymphopenia was more severe in males than females and levels of tumor necrosis factor alpha were reduced significantly in critical cases than severe and mild cases. 23.5% of severe cases and 24.4% of critical cases were co-infected with other respiratory pathogens. Additionally, stepwise multivariable regression analysis suggested that co-infection, lymphocyte count and levels of D-dimer were associated with severity of COVID-19.These findings provide crucial clues for further identification of the mechanisms, characteristics and treatments of patients with COVID-19.

Current prevalence, characteristics, and comorbidities of patients with COVID-19 in Indonesia

“…The finding was similar to earlier studies. 11,18,19 Sharma et al explained that symptoms of COVID-19 mostly began with dry cough, fever, fatigue and myalgia in the first four days. Then, dyspnea and purulent cough followed as the next naturally occurring symptoms until the 6 th day.…”

“…Chinese authorities recognized the novel type of Severe Acute Respiratory Syndrome, Coronavirus Disease 2019 (SARS-CoV-2 or COVID- 19) from a group of pneumonia cases in Wuhan City, Hubei Province, China, on January 7 th , 2020. This COVID-19 is a new strain of coronavirus that infects humans and mostly causes respiratory problems or sudden deaths.…”

COVID-19 and Sex Differences

“…In one study, 71% of patients who died of COVID-19 fulfilled the International Society of Thrombosis and Hemostasis criteria for disseminated intravascular coagulopathy compared with just 0.6% of survivors. 134 Moreover, evidence consistently shows the negative prognostic value of individual coagulation parameters, including elevated D- COVID-19 AND SEX DIFFERENCES dimer 12,46,85,135,136 and reduced platelet counts, 45,46,74,[135][136][137][138] both of which were significant after adjustment for multiple confounders. 139 In studies of COVID-19 patients with coagulation dysfunction, the composition of the patient population more commonly includes male patients, and possibly reflects the more severe disease that occurs in males.…”

Circulating Levels of Interleukin-6 and Interleukin-10, But Not Tumor Necrosis Factor-Alpha, as Potential Biomarkers of Severity and Mortality for COVID-19: Systematic Review with Meta-analysis

“…Besides IL-6, IL-10 is synthesized from regulatory T cells and even TH 1 cells and has been reportedly implicated in immunoregulation and inflammation [ 9 ], thereby highlighting the power of IL-10 to influence immune and inflammatory responses in the context of COVID-19. Indeed, a number of clinical studies have unveiled that circulating IL-6 levels were elevated in COVID-19 patients, particularly in those with severe stage and were positively associated with the severity and mortality of COVID-19 [ 10 – 33 ], commensurate with circulating levels of IL-10 and TNF-α [ 12 , 14 , 15 , 17 , 18 , 20 , 21 , 24 , 28 , 29 ]. Based on these previous findings, alterations in circulating levels of IL-6, IL-10, and TNF-α have been hypothesized to be biomarkers of disease severity and mortality for COVID-19.…”