Correlation between the variables collected at admission and progression to severe cases during hospitalization among COVID-19 patients in Chongqing.

BACKGROUND: Mortality is high among severe patients with 2019 novel coronavirus-infected disease (COVID-19). Early prediction of progression to severe cases is needed. METHODS: We retrospectively collected patients with COVID-19 in two hospital of Chongqing from January 1st to February 29th , 2020. At admission, we collected the demographics and laboratory tests to predict whether the patient would progress to severe cases in hospitalization. Severe case was confirmed when one of the following criteria occurred: 1) dyspnea, respiratory rate ≥30 breaths/min, 2) blood oxygen saturation ≤93%, and 3) PaO2 /FiO2 ≤300 mmHg. RESULTS: At admission, 348 mild cases were enrolled in this study. Of them, 20 (5.7%) patients progressed to severe cases after median 4.0 days (IQR: 2.3-6.0). Pulmonary inflammation index, platelet counts, sodium, C-reactive protein, prealbumin, and PaCO2 showed good distinguishing power to predict progression to severe cases (each AUC ≥0.8). Age, heart rate, chlorine, ALT, AST, procalcitonin, creatine kinase, pH, CD3 counts, and CD4 counts showed moderate distinguishing power (each AUC between 0.7-0.8). And potassium, creatinine, temperature, and D-dimer showed mild distinguishing power (each AUC between 0.6-0.7). In addition, higher C-reactive protein was associated with shorter time to progress to severe cases (r =-0.62). CONCLUSIONS: Several easily obtained variables at admission are associated with progression to severe cases during hospitalization. These variables provide a reference for the medical staffs when they manage the COVID-19 patients. This article is protected by copyright. All rights reserved.