Potential Factors for Prediction of Disease Severity of COVID-19 Patients

zhang, huizheng; wang, xiaoying; fu, zongqiang; Luo, Mi; Zhang, Zhen; Zhang, Ke; He, Ying; wan, dongyong; Zhang, Liwen; Wang, Jing; Yan, Xiaofeng; Han, Meng; chen, yaokai

doi:10.1101/2020.03.20.20039818

Cited by 63 publications

(58 citation statements)

References 27 publications

(53 reference statements)

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“…None of the BioRxiv posts were relevant to our topic. Of the 137 pre‐prints in MedRxiv, 23 nonduplicate studies included information on asthma, 29‐51 but none of them included specific information in children.…”

Section: Resultsmentioning

confidence: 99%

Asthma and COVID‐19 in children: A systematic review and call for data

Castro-Rodriguez

Forno

2020

Pediatric Pulmonology

104

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Rationale Whether asthma constitutes a risk factor for coronavirus disease‐2019 (COVID‐19) is unclear. Here, we aimed to assess whether asthma, the most common chronic disease in children, is associated with higher COVID‐19 risk or severity in pediatric populations. Methods We performed a systematic literature search in three stages: first, we reviewed PubMed, EMBASE, and CINAHL for systematic reviews of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and COVID‐19 in pediatric populations, and reviewed their primary articles; second, we searched PubMed for studies on COVID‐19 or SARS‐CoV‐2 and asthma/wheeze, and evaluated whether the resulting studies included pediatric populations; third, we repeated the second search in http://BioRxiv.org and http://MedRxiv.org to find pre‐prints that may have information on pediatric asthma. Results In the first search, eight systematic reviews were found, of which five were done in pediatric populations; none of the 67 primary studies included data on pediatric asthma as a comorbidity for COVID‐19. In the second search, we found 34 results in PubMed, of which five reported asthma in adults, but none included data on children. In the third search, 25 pre‐prints in MedRxiv included data on asthma, but none on children. We found one report by the US Centers for Disease Control and Prevention stating that 40/345 (~11.5%) children with data on chronic conditions had “chronic lung diseases including asthma,” and one from a tertiary hospital in New York that reported asthma in 11/46 (~23.9%) children hospitalized for COVID‐19. Conclusion There is scarcely any data on whether childhood asthma (or other pediatric respiratory diseases) constitute risk factors for SARS‐CoV‐2 infection or COVID‐19 severity. Studies are needed that go beyond counting the number of cases in the pediatric age range.

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Section: Resultsmentioning

confidence: 99%

Asthma and COVID‐19 in children: A systematic review and call for data

Castro-Rodriguez

Forno

2020

Pediatric Pulmonology

104

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“…Higher serum hypersensitive C-reactive protein (hs-CRP) is an important marker of poor prognosis in COVID-19 patients and can be used to predict the risk of death in severe patients, which reflects the persistent state of inflammation [40]. Increased PCT, SAA and ESR were identified as powerful factors to predict disease progression of patients with COVID-19 [41][42][43][44]. In addition, the combined detection of IL-6, ESR and CRP improve the efficiency of predicting the development of patients' condition [45].…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19

Bao

Zhang

et al. 2020

Clinica Chimica Acta

114

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Background: The pandemic coronavirus disease 2019 (COVID-19) has threaten the global health. The characteristics of laboratory findings of coronavirus are of great significance for clinical diagnosis and treatment. We found indicators that may most effectively predict a non-severe COVID-19 patient develop into a severe patient. Methods: We conducted a meta-analysis to compare the laboratory findings of severe patients with non-severe patients with COVID-19 from searched articles. Results: Through the analysis of laboratory examination information of patients with COVID-19 from 35 articles (5912 patients), we demonstrated that severe cases possessed higher levels of leukocyte (1.20-fold), neutrophil (1.33-fold), CRP (3.04-fold), PCT (2.00-fold), ESR (1.44-fold), AST (1.40-fold), ALT (1.34-fold), LDH (1.54-fold), CK (1.44-fold), CK-MB (1.39-fold), total bilirubin (1.14-fold), urea (1.28-fold), creatine (1.09-fold), PT (1.03fold) and D-dimer (2.74-fold), as well as lower levels of lymphocytes (1.44-fold), eosinophil (2.00-fold), monocyte (1.08-fold), Hemoglobin (1.53-fold), PLT (1.15-fold), albumin (1.15-fold), and APTT (1.02-fold). Lymphocyte subsets and series of inflammatory cytokines were also different in severe cases with the non-severe ones, including lower levels of CD4 T cells (2.10-fold) and CD8 T cells (2.00-fold), higher levels of IL-1β (1.02fold), IL-6 (1.93-fold) and IL-10 (1.55-fold). Conclusions: Some certain laboratory inspections could predict the progress of the COVID-19 changes, especially lymphocytes, CRP, PCT, ALT, AST, LDH, D-dimer, CD4 T cells and IL6, which provide valuable signals for preventing the deterioration of the disease.

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“…The dysregulation of immune response and excessive inflammation actually is key element of pathogenesis in COVID‐19 17,18 . And many immunity and inflammation‐related markers including C‐reactive protein (CRP), IL‐6, neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio have been confirmed associated with disease severity and mortality of COVID‐19 patients 19‐23 …”

Section: Introductionmentioning

confidence: 99%

The Prognostic Nutritional Index is associated with mortality of COVID‐19 patients in Wuhan, China

Wang

Yin

et al. 2020

Clinical Laboratory Analysis

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Background Declared as pandemic by WHO, the coronavirus disease 2019 (COVID‐19) pneumonia has brought great damage to human health. The uncontrollable spread and poor progression of COVID‐19 have attracted much attention from all over the world. We designed this study to develop a prognostic nomogram incorporating Prognostic nutritional index (PNI) in COVID‐19 patients. Methods Patients confirmed with COVID‐19 and treated in Renmin Hospital of Wuhan University from January to February 2020 were included in this study. We used logistic regression analysis to find risk factors of mortality in these patients. A prognostic nomogram was constructed and receiver operating characteristics (ROC) curve was drawn to evaluate the predictive value of PNI and this prognostic model. Results Comparison of baseline characteristics showed non‐survivors had higher age (P < .001), male ratio (P = .038), neutrophil‐to‐lymphocyte ratio (NLR) (P < .001), platelet‐to‐lymphocyte ratio (PLR) (P < .001), and PNI (P < .001) than survivors. In the multivariate logistic regression analysis, independent risk factors of mortality in COVID‐19 patients included white blood cell (WBC) (OR 1.285, P = .039), PNI (OR 0.790, P = .029), LDH (OR 1.011, P < .015). These three factors were combined to build the prognostic model. Area under the ROC curve (AUC) of only PNI and the prognostic model was 0.849 (95%Cl 0.811‐0.888) and 0.950 (95%Cl 0.922‐0.978), respectively. And calibration plot showed good stability of the prognostic model. Conclusion This research indicates PNI is independently associated with the mortality of COVID‐19 patients. Prognostic model incorporating PNI is beneficial for clinicians to evaluate progression and strengthen monitoring for COVID‐19 patients.

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Potential Factors for Prediction of Disease Severity of COVID-19 Patients

Cited by 63 publications

References 27 publications

Asthma and COVID‐19 in children: A systematic review and call for data

Asthma and COVID‐19 in children: A systematic review and call for data

Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19

The Prognostic Nutritional Index is associated with mortality of COVID‐19 patients in Wuhan, China

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