Title Longitudinal Profile of Laboratory Parameters and Their Application in the Prediction for Fatal Outcome Among Patients Infected With SARS-CoV-2: A Retrospective Cohort Study
Authors Zeng, Hao-Long
Lu, Qing-Bin
Yang, Qing
Wang, Xu
Yue, Dao-Yuan
Zhang, Lei-Ke
Li, Hao
Liu, Wei
Li, Hui-Jun
Affiliation Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Lab Med, Wuhan, Peoples R China
Peking Univ, Sch Publ Hlth, Dept Lab Sci & Technol, Beijing, Peoples R China
Wuhan Polytech Univ, Inst Food Sci & Engn, Wuhan, Peoples R China
Chinese Acad Sci, Wuhan Inst Virol, State Key Lab Virol, Wuhan, Peoples R China
Beijing Inst Microbiol & Epidemiol, State Key Lab Pathogen & Biosecur, Beijing 100071, Peoples R China
Issue Date 15-Feb-2021
Publisher CLINICAL INFECTIOUS DISEASES
Abstract Background. Patients with coronavirus disease 2019 (COVID-19) experience a wide clinical spectrum, with over 2% developing fatal outcome. The prognostic factors for fatal outcome remain sparsely investigated. Methods. A retrospective cohort study was performed in a cohort of patients with confirmed COVID-19 in one designated hospital in Wuhan, China, from 17 January-5 March 2020. The laboratory parameters and a panel of cytokines were consecutively evaluated until patients' discharge or death. The laboratory features that could be used to predict fatal outcome were identified. Results. Consecutively collected data on 55 laboratory parameters and cytokines from 642 patients with COVID-19 were profiled along the entire disease course, based on which 3 clinical stages (acute stage, days 1-9; critical stage, days 10-15; and convalescence stage, day 15 to observation end) were determined. Laboratory findings based on 75 deceased and 357 discharged patients revealed that, at the acute stage, fatality could be predicted by older age and abnormal lactate dehydrogenase (LDH), urea, lymphocyte count, and procalcitonin (PCT) level. At the critical stage, the fatal outcome could be predicted by age and abnormal PCT, LDH, cholinesterase, lymphocyte count, and monocyte percentage. Interleukin 6 (IL-6) was remarkably elevated, with fatal cases having a more robust production than discharged cases across the whole observation period. LDH, PCT, lymphocytes, and IL-6 were considered highly important prognostic factors for COVID-19-related death. Conclusions. The identification of predictors that were routinely tested might allow early identification of patients at high risk of death for early aggressive intervention.
URI http://hdl.handle.net/20.500.11897/611509
ISSN 1058-4838
DOI 10.1093/cid/ciaa574
Indexed SCI(E)
Appears in Collections: 公共卫生学院

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