Background
Methods
Study population and data collection
RT-PCR for SARS-CoV-2
Chest CT protocols and evaluation
Statistical analysis
Results
Demographics and clinical characteristics
Total (n = 102) | Non-survivor (n = 15) | Survivor (n = 87) | p value | |
---|---|---|---|---|
Characteristics | ||||
Age, years | 57 (45–70) | 69 (58–77) | 55 (44–66) | 0.003 |
< 65 | 70 (69%) | 6 (40%) | 64 (74%) | 0.010 |
≥ 65 | 32 (31%) | 9 (60%) | 23 (26%) | .. |
Sex | ||||
Female | 43 (42%) | 4 (27%) | 39 (45%) | 0.188 |
Male | 59 (58%) | 11 (73%) | 48 (55%) | .. |
Any Comorbidity | 44 (43%) | 9 (60%) | 35 (40%) | 0.153 |
Diabetes | 15 (15%) | 2 (13%) | 13 (15%) | 0.871 |
Hypertension | 31 (30%) | 7 (47%) | 24 (28%) | 0.138 |
Coronary heart disease | 4 (4%) | 2 (13%) | 2 (2%) | 0.042 |
Chronic obstructive pulmonary disease | 2 (2%) | 1 (7%) | 1 (1%) | 0.155 |
Malignancy | 5 (5%) | 0 (0%) | 5 (6%) | 1.000 |
Chronic liver disease | 3 (3%) | 0 (0%) | 3 (3%) | 1.000 |
Other | 28 (27%) | 5 (33%) | 23 (26%) | 0.580 |
Current smoker | 7 (7%) | 1 (7%) | 6 (7%) | 0.974 |
Symptoms and signs | ||||
Fever | 94 (92%) | 14 (93%) | 80 (92%) | 0.854 |
Highest temperature, °C | 38.6 (38.0–39.0) | 38.5 (38.0–38.9) | 38.6 (38.0–39.0) | 0.458 |
Chills | 23 (23%) | 3 (20%) | 20 (23%) | 0.798 |
Cough | 77 (75%) | 13 (87%) | 64 (74%) | 0.276 |
Sputum | 26 (25%) | 6 (40%) | 20 (23%) | 0.163 |
Dyspnea | 52 (51%) | 7 (48%) | 45 (52%) | 0.717 |
Hemoptysis | 5 (5%) | 1 (7%) | 4 (5%) | 0.732 |
Chest pain | 7 (7%) | 1 (7%) | 6 (7%) | 0.974 |
Headache | 18 (18%) | 3 (20%) | 15 (17%) | 0.796 |
Fatigue | 35 (34%) | 5 (33%) | 30 (34%) | 0.931 |
Nausea | 6 (6%) | 1 (7%) | 5 (6%) | 0.889 |
Diarrhea | 18 (18%) | 4 (27%) | 14 (16%) | 0.321 |
Myalgia | 24 (24%) | 3 (20%) | 21 (24%) | 0.727 |
Systolic pressure, mm Hg | 129.0 (112.0–144.0) | 144.0 (126.0–170.0) | 127.0 (112.0–141.0) | 0.009 |
Heart rate, beats per minute | 93.0 (80.0–103.0) | 102.0 (86.0–111.0) | 92.0 (80.0–103.0) | 0.161 |
Respiratory rate | 20.0 (20.0–24.0) | 24.0 (21.0–25.0) | 20.0 (20.0–23.0) | 0.003 |
> 20 breaths per min | 47 (46%) | 12 (80%) | 35 (40%) | 0.004 |
Time from symptom onset to hospital admission, days | 11.0 (7.0–16.0) | 9.0 (6.0–14.0) | 11.0 (8.0–18.0) | 0.291 |
Laboratory findings
Normal range | Total (n = 102) | Non-survivor (n = 15) | Survivor (n = 87) | p value | |
---|---|---|---|---|---|
White blood cell count, × 109/L | 4.00–10.00 | 6.0 (4.4–8.6) | 9.1 (5.5–11.2) | 5.8 (4.4–8.1) | 0.011 |
< 4 | 11 (11%) | 1 (7%) | 10 (11%) | 0.019 | |
4–10 | 75 (74%) | 8 (53%) | 67 (78%) | .. | |
> 10 | 16 (15%) | 6 (40%) | 10 (11%) | .. | |
Neutrophil count, × 109/L | 1.80–6.30 | 4.2 (2.9–6.8) | 8.0 (3.5–10.6) | 4.1 (2.8–6.2) | 0.006 |
Lymphocyte count, × 109/L | 1.10–3.20 | 0.9 (0.6–1.2) | 0.5 (0.4–0.8) | 0.9 (0.7–1.2) | 0.006 |
< 1·1 | 66 (65%) | 12 (80%) | 54 (62%) | 0.180 | |
≥1·1 | 36 (35%) | 3 (20%) | 33 (38%) | .. | |
Hemoglobin, g/L | 130.0–175.0 | 128.0 (115.0–138.0) | 120.0 (110.0–135.0) | 128.0 (115.0–139.0) | 0.571 |
Platelet count, × 109/L | 125.0–350.0 | 194.0 (152.0–250.5) | 113.0 (97.0–165.0) | 206.5 (162.8–267.5) | 0.001 |
< 125 | 16/101 (16%) | 9 (60%) | 7/86 (8%) | 0.000 | |
≥125 | 85/101 (84%) | 6 (40%) | 79/86 (92%) | .. | |
Lactate dehydrogenase, U/L | 135–225 | 294.5 (219.3–417.5) | 569.0 (362.0–664.0) | 272.0 (205.0–383.0) | 0.000 |
≤225 | 27 (26%) | 1 (7%) | 26 (30%) | 0.060 | |
> 225 | 75 (74%) | 14 (93%) | 61 (70%) | .. | |
D-dimer, μg/mL | ≤0·5 | 0.8 (0.5–1.7) | 2.1 (1.2–4.4) | 0.7 (0.4–1.5) | 0.000 |
≤0·5 | 28 (27%) | 1 (7%) | 27 (31%) | 0.002 | |
> 0·5 to ≤1 | 29 (28%) | 1 (7%) | 28 (32%) | .. | |
> 1 | 45 (45%) | 13 (86%) | 32 (37%) | .. | |
Prothrombin time, s | 11.5–14.5 | 14.2 (13.7–14.8) | 14.9 (14.1–17.1) | 14.1 (13.6–14.5) | 0.001 |
< 14.5 | 65 (64%) | 4 (27%) | 61 (70%) | 0.001 | |
≥14.5 | 37 (36%) | 11 (73%) | 26 (30%) | .. | |
International Normalized Ratio, INR | 0.80–1.20 | 1.08 (1.04–1.15) | 1.16 (1.08–1.37) | 1.08 (1.02–1.12) | 0.001 |
Hypersensitive troponin I, pg/mL | ≤34.2 | 5.2 (2.2–16.2) | 24.1 (13.0–202.1) | 4.3 (2.0–10.6) | 0.000 |
≤34.2 | 88/101 (87%) | 8 (53%) | 80/86 (93%) | 0.000 | |
> 34.2 | 13/101 (13%) | 7 (47%) | 6/86 (7%) | .. | |
NT-proB-type Natriuretic Peptide (BNP), pg/mL | < 241 | 131.0 (53.5–355.8) | 817.5 (348.5–3031.0) | 92.5 (42.3–266.5) | 0.000 |
< 241 | 64/100 (64%) | 1/14 (7%) | 63/86 (73%) | 0.000 | |
≥241 | 36/100 (36%) | 13/14 (93%) | 23/86 (27%) | .. | |
Albumin, g/L | 35–52 | 34.8 (31.7–39.5) | 31.5 (28.5–34.0) | 36.5 (32.5–39.8) | 0.002 |
< 35 | 52 (51%) | 13 (97%) | 39 (45%) | 0.003 | |
≥35 | 50 (49%) | 2 (13%) | 48 (55%) | .. | |
Alanine aminotransferase, U/L | ≤41 | 23.0 (14.0–34.3) | 17.0 (13.0–29.0) | 23.0 (14.0–35.0) | 0.223 |
≤41 | 86 (84%) | 14 (93%) | 72 (83%) | 0.298 | |
> 41 | 16 (16%) | 1 (7%) | 15 (17%) | .. | |
Aspartate aminotransferase, U/L | ≤40 | 26.0 (19.0–41.8) | 34.0 (24.0–54.0) | 25.0 (19.0–38.0) | 0.187 |
≤40 | 75 (74%) | 9 (80%) | 66 (76%) | 0.198 | |
> 40 | 27 (26%) | 6 (20%) | 21 (24%) | .. | |
Total bilirubin, μmol/L | ≤26 | 8.5 (6.6–11.6) | 8.4 (6.6–15.3) | 8.5 (6.6–11.4) | 0.752 |
Creatinine, μmol/L | 59–104 | 68.0 (59.5–84.3) | 94.0 (63.0–164.0) | 67.0 (58.0–84.0) | 0.014 |
≤104 | 89 (87%) | 9 (60%) | 80 (92%) | 0.001 | |
> 104 | 13 (13%) | 6 (40%) | 7 (8%) | .. | |
Blood urea nitrogen, mmol/L | 3.6–9.5 | 4.6 (3.2–6.2) | 9.2 (5.4–13.7) | 4.3 (3.2–5.5) | 0.000 |
≤9.5 | 91 (89%) | 8 (53%) | 83 (96%) | 0.000 | |
> 9.5 | 11 (11%) | 7 (47%) | 4 (4%) | .. | |
Potassium, mmol/L | 3.50–5.10 | 4.2 (3.8–4.5) | 4.4 (3.6–5.1) | 4.1 (3.8–4.5) | 0.171 |
< 3.5 | 13 (13%) | 2 (13%) | 11 (13%) | 0.012 | |
3.5–5.1 | 81 (79%) | 9 (60%) | 72 (83%) | .. | |
> 5.1 | 8 (8%) | 4 (27%) | 4 (4%) | .. | |
Sodium, mmol/L | 136–145 | 137.7 (135.8–141.1) | 138.6 (133.9–142.6) | 137.6 (136.0–141.1) | 0.970 |
< 136 | 26 (25%) | 5 (33%) | 21 (24%) | 0.248 | |
136–145 | 74 (73%) | 9 (60%) | 65 (75%) | .. | |
> 145 | 2 (2%) | 1 (7%) | 1 (1%) | .. | |
Calcium, mmol/L | 2.20–2.55 | 2.1 (2.0–2.2) | 2.0 (1.9–2.2) | 2.1 (2.1–2.3) | 0.004 |
< 2.2 | 70 (69%) | 14 (93%) | 56 (64%) | 0.026 | |
≥2.2 | 32 (31%) | 1 (7%) | 31 (36%) | .. | |
Procalcitonin, ng/mL | < 0.05 | 0.06 (0.03–0.15) | 0.19 (0.12–0.60) | 0.05 (0.03–0.10) | 0.000 |
< 0·05 | 40 (39%) | 0 (0%) | 40 (46%) | 0.000 | |
≥0·05 | 62 (61%) | 15 (100%) | 47 (54%) | .. | |
High-sensitivity C-reactive Protein (hs-CRP), mg/L | < 1 | 34.0 (5.8–86.6) | 78.7 (51.3–166.3) | 25.4 (3.9–81.3) | 0.003 |
< 3 | 16 (16%) | 0 (0%) | 16 (18%) | 0.119 | |
≥3 | 86 (84%) | 15 (100%) | 71 (82%) | .. | |
IL-1β, pg/ml | < 5 | 4.9 (4.0–4.9) | 4.5 (4.0–4.9) | 4.9 (4.0–4.9) | 0.388 |
IL-2R, U/ml | 223–710 | 605.5 (380.8–896.8) | 1166.5 (898.8–1788.5) | 571.5 (353.0–821.8) | 0.001 |
IL-6, pg/ml | < 7 | 4.7 (2.2–20.3) | 48.4 (12.6–154.1) | 4.2 (1.9–16.4) | 0.000 |
IL-8, pg/ml | < 62 | 10.2 (6.7–19.9) | 22.0 (14.0–28.4) | 9.3 (6.4–18.6) | 0.006 |
IL-10, pg/ml | < 9.1 | 4.9 (4.0–4.9) | 4.9 (4.0–10.0) | 4.9 (4.0–4.9) | 0.601 |
TNF-α, pg/ml | < 8.1 | 7.5 (5.6–10.1) | 13.0 (8.3–23.3) | 7.3 (5.6–9.4) | 0.006 |
Radiographic findings
Week 1 (≤ 7d) after symptom onset | Week 2 (> 7d, ≤ 14d) | Week 3(>14d, ≤ 21d) | Week 4(>21d, ≤ 28d) | ||
---|---|---|---|---|---|
Survivor (n = 21) | Non-Survivor (n = 11) | Survivor(n = 22) | Survivor(n = 25) | Survivor(n = 23) | |
Severity score of each lobe | |||||
Right upper lobe | 1 (0–1.5) | 3 (2–4)*** | 2 (1–2) | 1 (0.5–2) | 1 (0–2) |
Right middle lobe | 0 (0–1) | 2 (1–2) | 1 (0–1) | 0 (0–1) | 0 (0–1) |
Right lower lobe | 1 (1–3) | 3 (3–4) | 2.5 (1–3) | 1 (1–2.5) | 1 (1–2) |
Left upper lobe | 1 (0–1.5) | 3 (1–4) | 1.5 (0–3) | 1 (0–2) | 1 (0–2) |
Left lower lobe | 1 (0–2.5) | 4 (3–5)*** | 2 (1–3.25) | 1 (1–2.5) | 1 (0–2) |
Total severity score | 4 (2–9.5) | 15 (9–19)**** | 8 (4–12.25) | 5 (3–10) | 4 (2–9) |
< 15 | 20 (95.24%) | 4 (36.36%)*** | 19 (86.36%) | 23 (92%) | 22 (95.65%) |
≥ 15 | 1 (4.76%) | 7 (63.64%) | 3 (13.64%) | 2 (8%) | 1 (4.35%) |
Number of involved lobes | 3 (1.5–5) | 5 (4–5)** | 4.5 (3–5) | 4 (3–5) | 3 (2–5) |
< 5 | 14 (66.67%) | 2 (18.18%)* | 11 (50%) | 15 (60%) | 14 (60.87%) |
= 5 | 7 (33.33%) | 9 (81.82%) | 11 (50%) | 10 (40%) | 9 (39.13%) |
Lung involvement | |||||
No involvement | 2 (9.52%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
Unilateral | 4 (19.05%) | 0 (0%) | 0 (0%) | 4 (16%) | 3 (13.04%) |
Bilateral | 15 (71.43%) | 11 (100%) | 22 (100%) | 21 (84%) | 20 (86.96%) |
Patterns of opacification | |||||
Ground glass opacity | 20 (95.24%) | 10 (90.91%) | 21 (95.45%) | 18 (72%) | 20 (86.96%) |
Crazy-paving pattern | 2 (9.52%) | 5 (45.45%)* | 5 (22.72%) | 3 (12%) | 4 (17.39%) |
Consolidation | 9 (42.86%) | 9 (81.82%) | 15 (68.19%) | 14 (56%) | 1 (4.35%)** |
Reticulation | 0 (0%) | 2 (18.18%) | 3 (13.64%) | 9 (36%)** | 15 (65.22%)**** |
Pleural effusion | 1 (4.76%) | 3 (27.27%) | 1 (4.55%) | 0 (0%) | 0 (0%) |
Distribution of opacification | |||||
No lesion | 2 (9.52%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
Peripheral | 10 (47.62%) | 8 (72.73%) | 13 (59.09%) | 18 (72%) | 17 (73.91%) |
Random | 6 (28.57%) | 0 (0%) | 2 (9.09%) | 0 (0%)** | 0 (0%)** |
Diffuse | 3 (14.29%) | 3 (21.27%) | 7 (31.82%) | 7 (28%) | 6 (26.09%) |
Time between symptom onset and CT scan | 4 (2.5–5) | 5 (2–6) | 11.5 (9–13.25) | 18 (16–20) | 26 (24–28) |