Epidemiological and clinical features of COVID-19 patients with and without pneumonia in Beijing, China

Abstract

Background: SARS-CoV-2-caused coronavirus disease (COVID-19) is posing a large casualty. The features of COVID-19 patients with and without pneumonia, SARS-CoV-2 transmissibility in asymptomatic carriers, and factors predicting disease progression remain unknown. Methods: We collected information on clinical characteristics, exposure history, and laboratory examinations of all laboratory-confirmed COVID-19 patients admitted to PLA General Hospital. Cox regression analysis was applied to identify prognostic factors. The last follow-up was February 18, 2020. Results: We characterized 55 consecutive COVID-19 patients. The mean incubation was 8.42 (95% confidence interval [CI], 6.55-10.29) days. The mean SARS-CoV-2-positive duration from first positive test to conversion was 9.71 (95%CI, 8.21-11.22) days. COVID-19 course was approximately 2 weeks. Asymptomatic carriers might transmit SARS-CoV-2. Compared to patients without pneumonia, those with pneumonia were 15 years older and had a higher rate of hypertension, higher frequencies of having a fever and cough, and higher levels of interleukin-6 (14.61 vs. 8.06pg/mL, P=0.040), B lymphocyte proportion (13.0% vs.10.0%, P=0.024), low account (<190/µL) of CD8 + T cells (33.3% vs. 0, P=0.019). Multivariate Cox regression analysis indicated that circulating interleukin-6 and lactate independently predicted COVID-19 progression, with a hazard ratio (95%CI) of 1.052 (1.000-1.107) and 1.082 (1.013-1.155), respectively. During disease course, T lymphocytes were .CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(which was not peer-reviewed) The copyright holder for this preprint .

An anti-CD6 monoclonal antibody (itolizumab) reduces circulating IL-6 in severe COVID-19 elderly patients

“…Different methods, different specimens (serum or plasma) and the different classi cation of disease severity could explain this heterogeneity. However, the highest concentrations of IL-6 are always in association with severe disease [3,5,27,28], which is in line with our results.…”

IL-6 signalling pathway inactivation with siltuximab in patients with COVID-19 respiratory failure: an observational cohort study

“…This compassionate-use program was initiated to understand the feasibility of suppressing CRP production with siltuximab and improving the outcomes in patients with COVID-19 requiring CPAP or NIV for pneumonia/ARDS treatment. Initial evidence from China where the first cases of COVID-19 emerged, indicate that excessive production inflammatory markers, such as IL-6 and CRP, correlate with severity of disease (Chen X et al 2020;Conti P et al 2020;Diao B et al 2020;Gong J et al 2020;Liu et al 2020;Yang et al 2020), and many more studies report a significant increase in IL-6 or CRP levels in patients with severe or critical COVID-19 compared with those patients with mild disease (Cai et al 2020;Chen J et al 2020;Feng C et al 2020;Huang Y et al 2020;Liu J et al 2020;Qin C et al 2020;Ruan Q et al 2020;Shi Y et al 2020;Wang Y et al 2020;Wang Z et al 2020;Wu C et al2020;Xu W et al 2020;Xu X et al 2020;Zeng Q et al 2020;Zhao Z et al 2020;Zhang B et al 2020;Zhou F et al 2020;Zhou Y et al 2020).…”

Interleukin-6 as a potential biomarker of COVID-19 progression

“…Although most cases were mild to moderate, some patients developed severe symptoms characterized by respiratory dysfunction and/or multiple organ failure [3]. In the current situation, identification of COVID-19 disease progression mainly relies on the clinical manifestation, while no effective biomarker has been proposed.…”

“…We initially identified 73 articles based on our search strategy, 64 of which were excluded after title, abstract, or full-text reading, because they were review articles, did not report IL-6 levels, or did not classify the condition of COVID-19 patients as non-severe and severe. Finally, only nine studies were included in this meta-analysis [1][2][3][4][5][6][7][8][9]. Although the heterogeneity was considerably high (I 2 = 89%; P < 0.00001), we observed that IL-6 levels were significantly increased in COVID-19-infected patients with severe condition compared with those with non-severe condition (SMD = 0.71, 95%CI −0.31-1.12, P = 0.0005) ( Fig.…”