Analysis of clinical features and related factors of coronavirus disease 2019 in Shanghai
JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)
2020, 40 (05):
Objective · To explore the common clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected local patients in Shanghai and their related influencing factors. Methods · A total of 320 patients admitted to Shanghai Public Health Clinical Center from January to March 2020 and diagnosed as having coronavirus disease 2019 (COVID-19) were selected. Clinical data of the patients were collected to analyze their characteristics. Using the statistical operation formula of R language, the correlation analysis of hospitalization days, days of increased hypersensitive C-reactive protein concentration (allergic days), days of lung CT improvement (CT days), and days required for nucleic acid turning negative with the main clinical manifestations and laboratory data was carried out. The correlation factors affecting the above four variables were analyzed. Results · Among the 320 patients, the proportions of mild type, moderate type, serious type and critical type were 6.25%, 83.44%, 6.88% and 3.44%, respectively; 91.25% of them had a history of exposure to Hubei. The proportions of fever, cough, sputum and fatigue were 79.06%, 46.56%, 21.56% and 15.31%, respectively. Spearman correlation analysis showed that the concentrations of lactate dehydrogenase, interleukin-2 (IL-2) and IL-6 were positively correlated with the above four variables, respectively (all P<0.05), albumin concentration was negatively correlated with allergic days (P=0.018), and CD4+ cell count was negatively correlated with CT days and days required for nucleic acid turning negative (both P<0.05). Stepwise multiple linear regression analysis showed that procalcitonin (PCT) concentration was negatively correlated with hospitalization days, CT days and allergic days (both P<0.05), and disease type was positively correlated with hospitalization days, allergic days, CT days and days required for nucleic acid turning negative (all P<0.05). Conclusion · Moderate type is common in the local patients in Shanghai; fever, cough and fatigue are common symptoms, and most of the patients are accompanied by lung CT abnormalities. The therapeutic effect and prognosis of these patients are closely related to disease type, concentrations of PCT and IL-6, as well as CD4+ cell count.
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