Retrospective Cohort Study
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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3047-3059
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3047
Table 1 Characteristics of the patient cohort
Characteristic All patients (n = 325) Survivornon-survivor (n = 308); (n = 17) P value Age < 0.0011 Median (IQR)-yr 45.0 (34.0-61.0) 43.0 (33.0-61.0) 63.0 (57.0-76.0) Distribution-no./total no. (%) 20-49 yr 178 178 (57.8) 0 (0.0) 50-64 yr 91 80 (25.9) 11 (64.7) ≥ 65 yr 56 50 (16.2) 6 (35.3) Male sex - no./total no. (%) 137 (42.2) 124 (40.3) 13 (76.5) 0.0031 Smoking history - no./total no. (%) 21 (6.5) 18 (5.8) 3 (17.7) 0.054 Exposure to source of transmission within past 14 days - no./total no. 0.0351 Yes 233 (71.7) 222 (4.9) 11 (66.8) No 92 (28.3) 86 (0.3) 6 (28.0) Median incubation period (IQR) - days 5.0 ± 4.0 5.0 ± 3.9 5.2 ± 3.5 0.862 Fever on admission Patients - no./total no. (%) 252 (77.5) 240 (77.9) 12 (70.6) 0.550 Median temperature (IQR) - °C Distribution of temperature - no./total no. (%) 0.603 < 37.3 °C 77 (23.7) 72 (22.2) 5 (1.5) 37.3-38.0 °C 106 (32.6) 103 (31.7) 3 (0.9) 38.1-39.0 °C 124 (38.2) 116 (35.7) 8 (2.5) > 39.0°C 18 (5.5) 17 (5.2) 1 (0.3) Symptoms - no. (%) Conjunctival congestion 1 (0.31) 1 (0.31) 0 (0.0) 1.000 Headache 52 (16) 51 (16.6) 1 (5.9) 0.243 Cough 207 (63.7) 199 (64.6) 8 (47.1) 0.143 Sputum production 81 (24.9) 76 (24.6) 5 (29.4) 0.660 Fatigue 156 (48) 145 (47.1) 11 (64.7) 0.157 Difficulty breathing 15 (4.6) 13 (4.2) 2 (11.8) 0.149 Shortness of breath 73 (22.5) 68 (22.1) 5 (29.4) 0.0121 Nausea or vomiting 25 (7.7) 21 (6.8) 4 (23.5) 0.0121 Diarrhea 28 (8.6) 27 (8.8) 1 (5.9) 0.680 Myalgia or arthralgia 92 (28.3) 88 (28.5) 4 (23.5) 0.630 Chills 55 (16.9) 54 (17.5) 1 (5.88) 0.212 Coexisting disorder - no. (%) Fatty liver 15 (4.6) 15 (4.9) 0 (0) 1.000 Chronic obstructive pulmonary disease 17 (5.2) 16 (5.2) 1 (5.9) 0.608 Diabetes 34 (10.5) 27 (8.77) 7 (41.2) < 0.0011 Hypertension 69 (21.2) 58 (18.8) 11 (64.7) < 0.0011 Coronary heart disease 9 (2.8) 6 (1.9) 3 (17.7) < 0.0011 Cerebrovascular disease 18 (5.5) 14 (4.6) 4 (23.5) 0.0101 Hyperlipidemia 17 (5.2) 16 (5.2) 1 (5.8) 0.901 Hepatitis B infection 6 (1.9) 5 (1.6) 1 (5.9) 0.205
Table 2 Laboratory findings of the patient cohort
Variable All patients (N = 325) Survivor non-survivor (n = 308); (n = 17) P value Laboratory findings White-cell count (109 /L) 4.6 (3.3-6.0) 4.6 (3.29-5.9) 6.4 (3.6-7.4) 0.090 Red-cell count (1012 /L) 4.3 (4.1-4.7) 4.3 (4.1-4.7) 4.2 (4.0-4.6) 0.557 Hemoglobin (g/L) 131.0 (120.0-142.0) 131.0 (121.0-142.5) 130.0 (114.0-141.0) 0.360 Platelet count (109 /L) 171.0 (134.0-202.0) 173.0 (136.0-204.5) 143.0 (119.0-155.0) 0.0081 Hematocrit (%) 39.4 (36.5-42.6) 39.4 (36.6-42.6) 40.0 (34.6-42.6) 0.530 Neutrophil percentage (%) 64.6 (56.8-75.5) 64.5 (56.4-75.2) 73.4 (67.3-81.8) 0.0071 Lymphocyte percentage (%) 26.5 ± 14.5 26.6 ± 12.3 18.6 (11.2-22.5) 0.0081 Monocyte percentage (%) 7.9 ± 3.5 8.1 ± 3.5 6.2 (3.4-6.9) 0.0081 Eosinophil percentage (%) 0.1 (0.0-0.6) 0.1 (0.0-0.55) 0.0 (0.0-0.8) 0.953 Basophil percentage (%) 0.2 (0.1-0.3) 0.2 (0.1-0.3) 0.2 (0.1-0.3) 0.946 Mean red blood cell volume (fL) 90.6 (87.5-93.6) 90.6 (87.6-93.6) 88.9 (85.7-93.1) 0.432 Mean hemoglobin content (pg) 30.0 (28.8-31.1) 30.0 (28.9-31.1) 29.4 (27.5-30.5) 0.209 Mean hemoglobin concentration (g/L) 330.0 (323.0-336.0) 330.0 (323.0-336.0) 324.0 (321.0-331.0) 0.0291 RBC distribution width standard deviation (%) 39.4 (36.7-41.2) 39.2 (36.5-41.2) 40.7 (37.5-42.8) 0.071 RBC distribution width-coefficient of variation (%) 12.7 (12.2-14.4) 12.7 (12.1-14.1) 13.3 (12.6-15.4) 0.116 Neutrophil count (109 /L) 2.96 (1.92-4.05) 2.9 (1.9-4.0) 4.1 (2.7-4.9) 0.0351 Lymphocyte count (109 /L) 1.13 ± 0.55 1.14 ± 0.55 0.89 ± 0.58 0.0351 Monocyte count (109 /L) 0.34 (0.24-0.46) 0.3 (0.3-0.5) 0.3 (0.2-0.5) 0.828 Eosinophil count (109 /L) 0.01 (0.0-0.02) 0.01 (0.0-0.02) 0.0 (0.0-0.06) 0.642 Basophil count (109 /L) 0.01 (0.01-0.02) 0.01 (0.01-0.02) 0.01 (0.01-0.02) 0.060 Platelet distribution width (%) 12.5 (10.6-16.2) 12.5 (10.6-16.2) 15.1 (10.9-16.4) 0.452 Large platelet ratio (%) 11.1 (9.8-21.2) 11.1 (9.8-21.4) 10.0 (10.0-12.9) 0.405 Mean platelet volume (fL) 19.0 (10.0-28.7) 18.5 (9.9-27.9) 28.9 (18.8-32.4) 0.0181 Platelet hematocrit (%) 0.17 (0.14-0.20) 0.17 (0.14-0.20) 0.13 (0.13-0.16) 0.0161 Distribution of other findings-no./total no. (%) Systolic blood pressure (mmHg) 123.6 ± 13.6 123.0 ± 12.7 135.4 ± 21.0 0.0221 Diastolic blood pressure (mmHg) 76.4 ± 9.5 76.4 ± 9.3 76.2 ± 13.1 0.464 Blood glucose concentration (mmol/L) 6.4 ± 2.6 6.2 ± 2.3 9.1 ± 4.8 0.0091 Total cholesterol (mmol/L) 3.8 (3.2-4.5) 3.9 (3.3-4.5) 2.7 (2.6-3.3) 0.0031 Triglyceride (mmol/L) 1.1 (0.8-1.4) 1.1 (0.8-1.4) 0.9 (0.8-1.0) 0.455 High density lipoprotein (mmol/L) 1.1 (0.9-1.2) 1.1 (0.9-1.3) 0.97 (0.94-1.12) 0.354 Low density lipoprotein (mmol/L) 2.2 ± 0.7 2.2 ± 0.7 1.5 ± 0.6 0.0021 C-reactive protein (mg/dL) 1.3 (0.3-3.4) 1.3 (0.3-3.0) 5.9 (3.3-8.2) < 0.0011 Lactate dehydrogenase (U/L) 178.5 (137.5-236.5) 173.0 (136.0-229.0) 275.0 (232.0-324.0) < 0.0011 Aspartate aminotransferase (U/L) 22.2 (17.1-32.8) 21.7 (16.8-32.3) 31.2 (25.5-36.5) 0.0191 Alanine aminotransferase (U/L) 19.1 (12.8-32.6) 18.9 (12.7-33.2) 19.9 (15.5-29.7) 0.957 γ–Glutamyltransferase (U/L) 19.0 (12.6-38.2) 19.0 (12.4-38.0) 27.8 (16.9-69.0) 0.064 Blood urea nitrogen (mmol/L) 4.1 (3.2-5.3) 4.0 (3.2-5.0) 6.4 (5.3-11.1) < 0.0011 Creatine kinase (ng/mL) 76.5 (45.0-140.0) 77.1 (45.0-138.0) 74.0 (61.0-203.0) 0.404 Creatinine (μmol/L) 63.9 (53.6-76.7) 63.0 (53.1-74.7) 83.7 (74.9-254.2) < 0.0011 α-Hydroxybutyrate dehydrogenase (U/L) 137.5 (109.0-176.5) 135.0 (108.0-171.0) 208.0 (158.0-217.0) 0.0011 D-dimer (μg/mL) 0.4 (0.2-0.8) 0.4 (0.2-0.8) 1.1 (0.6-6.3) < 0.0011 Procalcitonin (ng/mL) 0.05 (0.04-0.09) 0.05 (0.03-0.08) 0.3 (0.1-2.8) < 0.0011 Brain Natriuretic peptide (pg/mL) 34.4 (13.0-128.0) 31.6 (12.0-108.0) 295.8 (177.0-406.1) < 0.0011 Antihypertensive drugs < 0.0011 Yes 57 (17.5) 47 (14.5) 10 (3.0) No 268 (82.5) 261 (80.3) 7 (2.2) Hypoglycemic drugs < 0.0011 Yes 28 (8.6) 22 (6.8) 6 (1.8) No 297 (91.4) 286 (88) 11 (3.4) Lipid-lowering drugs 0.0051 Yes 14 (4.3) 11 (3.4) 3 (0.9) No 311 (95.7) 297 (91.4) 14 (4.3)
Table 3 The computed tomography score of the pulmonary involvement in four stages
Stage-1 (n = 157) Stage-2 (n = 194) Stage-3 (n = 165) Stage-4 (n = 211) Stage-5 (n = 204) Stage-6 (n = 137) P value Total CT score of the pulmonary involvement 2 ± 4 (0-18) 5 ± 5 (0-22) 7 ± 7 (0-22) 7 ± 7 (0-25) 5 ± 7 (0-24) 4 ± 6 (0-25) < 0.00011 Number of involved lobes 22 ± 2 (0-5) 3 ± 2 (1-5) 4 ± 2 (1-5) 3 ± 2 (1-5) 3 ± 2 (1-5) 4 ± 2 (1-5) < 0.00011 CT score in each lobe < 0.00011 Left upper lobe 0 ± 1 (0-3) 1 ± 2 (0-5) 1 ± 2 (0-5) 1 ± 2 (0-5) 1 ± 2 (0-4) 1 ± 1 (0-5) Left lower lobe 1 ± 1 (0-5) 1 ± 2 (0-5) 2 ± 2 (0-5) 2 ± 1 (0-5) 1 ± 2 (0-5) 1 ± 2 (0-5) Right upper lobe 0 ± 1 (0-3) 1 ± 2 (0-5) 1 ± 2 (0-5) 1 ± 2 (0-5) 1 ± 2 (0-5) 1 ± 2 (0-5) Right middle lobe 0 ± 1 (0-3) 1 ± 1 (0-5) 1 ± 2 (0-5) 1 ± 2 (0-5) 1 ± 1 (0-5) 0 ± 1 (0-5) Right lower lobe 1 ± 2 (0-12) 2 ± 1 (0-5) 2 ± 2 (0-5) 1 ± 2 (0-5) 1 ± 1 (0-5) 1 ± 1 (0-5)
Table 4 Distribution and frequency of the major of lung lesions on computed tomography in different stages defined by the time of onset of symptoms
Stage-1 (n = 157) Stage-2 (n = 194) Stage-3 (n = 165) Stage-4 (n = 211) Stage-5 (n = 204) Stage-6 (n = 137) Distribution of pulmonary lesions No lesion 12/157 1/194 0/165 1/211 2/204 0/137 Peripheral 60/157 18/194 55/165 105/211 88/204 66/137 Random 85/157 162/194 88/165 75/211 78/204 44/137 Diffuse 0/157 13/194 22/165 30/211 36/204 27/137 Involvement of the lesions No involvement 12/157 0/194 0/165 0/211 0/204 0/137 Single lobe 48/157 18/194 11/165 30/211 22/204 11/137 Bilateral multilobe GGO 96/157 180/194 154/165 180/211 176/204 121/137 None 24/157 0/194 22/165 30/211 47/204 49/137 Yes 133/157 194/194 143/165 181/211 157/204 88/137 Crazy-paving pattern None 120/157 104/194 110/165 180/211 183/204 126/137 Yes 36/157 90/194 55/165 31/211 121/204 11/137 Consolidation None 157/157 140/194 88/165 105/211 102/204 89/137 Yes 0/157 54/194 77/165 105/211 102/204 48/137 Fibrosis None 157/157 180/194 143/165 150/211 102/204 37/137 Yes 0/157 14/194 22/165 61/211 102/204 100/137
Table 5 Associations of risk factors with incident mortality risk of coronavirus disease 2019
Variable HR (95%CI) P for overall association P for nonlinear association Model 1 Model 2 Age (per year increase) 1.06 (1.03, 1.10) 1.04 (1.01, 1.09) 0.080 0.805 CRP (per 1 mg/L increase) 1.15 (1.06, 1.24) 1.10 (1.01, 1.23) 0.062 0.715 DD (per 1 μg/mL increase of NLT 1.89 (1.34, 2.69) 1.63 (1.03, 2.58) 0.012 0.711 LDH (per 10 U/L increase) 1.06 (1.02, 1.09) 1.04 (1.01, 1.10) 0.080 0.805 Procalcitonin (per 1 ng/mL increase of NLT) 2.15 (1.59, 2.90) 1.88 (1.22, 2.88) 0.011 0.721
Table 6 Associations of risk factors with severe cases incident risk of coronavirus disease 2019
Variable OR (95%CI) P for overall association P for nonlinear association Model 1 Model 2 Age (per year increase) 1.06 (1.04, 1.08) 1.04 (1.01, 1.07) 0.010 0.192 WBC (per 1 × 109 /L increase) 1.27 (1.11, 1.46) 1.20 (1.01, 1.45) 0.003 0.046 FBG (per 1 mmol/L increase) 1.19 (1.07, 1.33) 1.15 (1.01, 1.32) 0.036 0.064 Total cholesterol (per 1 mmol/L increase) 1.43 (1.07, 1.91) 1.65 (1.09, 2.50) 0.028 0.260 LDH (per 10 U/L increase) 1.09 (1.05, 1.13) 1.06 (1.02, 1.10) 0.009 0.268 Procalcitonin (per 1 ng/mL increase of NLT) 2.26 (1.68, 3.05) 1.75 (1.16, 2.65) 0.007 0.099