Xiao-Hua Zhang,Xiao-Bao Teng,Jing-Feng Shi,Ming-Feng Han
Severe novel coronavirus pneumonia: Clinical characteristics and risk factors
Severe novel coronavirus pneumonia: Clinical characteristics and risk factors

Dear editor, At present, the domestic and foreign studies on the risk factors of severe COVID-19 are still unable to comprehensively and systematically reflect many factors affecting the prognosis of patients with severe COVID-19. We collected and analyzed the general characteristics, clinical characteristics, laboratory and imaging results, and treatment plans of inpatients with severe and general COVID-19, to explore and analyze the risk factors of severe COVID-19 conversion, in order to earlier identify the most critically affected patients, and reduce the severity of the disease. Using the Hospital Information System (HIS) of Fuyang Second People's Hospital, the data on patients with COVID-19 diagnosed from January 21, 2020, to March 4, 2020, were retrieved. The general data (gender, age, clinical symptoms, epidemiological characteristics, and underlying diseases), laboratory data (routine blood test, biochemical test, serum amyloid A (SAA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), interleukin 6 (IL-6) and T cell subsets), imaging results, and treatment plans were recorded in detail. Data were processed using statistical analysis software SPSS 22.0. Of 85 patients, there were 31 patients in the severe group (severe and critical patients) and 54 patients in the general group (general patients). In aspects of clinical symptoms, the fever time was significantly longer, the incidence of chest tightness and dyspnea symptoms was significantly higher in the severe group than in the general group, and the differences were statistically significant (P < 0.05). The differences in neutrophil count, lymphocyte count, albumin, urea nitrogen, fasting blood glucose, lactate dehydrogenase (LDH), CRP, SAA, IL-6, ESR, D-Dimer (DIC), and CD4+ T and CD8+ T cell levels between the severe group and general group were statistically significant (P < 0.05). Neutrophils and urea nitrogen in most of the patients were in the normal range but in the severe group the WBC count, neutrophil count, urea nitrogen, fasting blood glucose, CRP, LDH, IL-6, ESR, and DIC were higher than in the general group (P < 0.05), and the absolute lymphocyte value, CD4+ T, CD8+ T, and albumin count were significantly lower than in the general group (P < 0.01, Table 1 ). In imaging, COVID-19 is mainly characterized by multiple patchy and ground-glass shadows in both lungs, with obvious extrapulmonary zones. A few patients are characterized by single lung lesions. In the severe group, only two patients were characterized by single lung lesions, and in the general group, five patients were characterized by single lung lesions. The difference between the two groups was not statistically significant. The remaining patients were characterized by multiple patchy and ground-glass shadows in both lungs, with obvious extrapulmonary zones. Consolidation may occur in critical patients (Fig. 1 ). Patients with COVID-19 are often older, with complications from underlying diseases. Patients with persistent fever, chest tightness, dyspnea, increased IL-6 and LDH levels, and decreased CD4+T cell counts are more likely to develop severe or critical conditions.

First batch of novel coronary pneumonia prevention and control emergency science and technology projects of Fuyang City (FK20201002).