Clinical characteristics and predictors of disease progression in severe patients with COVID-19 infection in Jiangsu Province, China: a descriptive study

Background We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province We studied the clinical characteristics and therapies of severe cases in Jiangsu Province Methods A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020 The improvement and deterioration subgroups were compared to identify predictors of disease progression Results A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study Up until April 20, 2020, the mortality of severe patients was 0% The median age was 57 years The average body mass index (BMI) of these patients was 25 kg/m� White blood cell counts decreased in 45 0% of patients, lymphopenia in 63 3%, thrombocytopenia in 13 3%, and procalcitonin levels in 88 3% of the patients were less than 0 5 ng/mL There were no statistically significant differences in immunoglobulin therapy and glucocorticoids therapy between the improvement and deterioration subgroups Logistic regression analysis identified higher levels of troponin T (odds ratio [OR]: 1 04;95% confidence interval [CI]: 1 00-1 08;P=0 04), antiviral therapy with aerosol inhalation of interferon (OR: 6 33;95% CI: 1 18-33 98;P=0 03), and the application of non-invasive mechanical ventilation (OR: 1 99;95%CI: 1 17-3 41;P=0 01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0 11;95% CI: 0 02-0 57;P=0 01) and early prone ventilation were associated with improvement (OR: 0 11;95% CI: 0 01-0 98;P=0 04) Conclusions COVID-19 infection had a low mortality rate in Jiangsu Province, China The higher levels of troponin T and lower lymphocyte count were predictors of disease progression Early prone ventilation may be an effective treatment for severe cases