Objective To investigate the difference of clinical characteristics and prognosis between severe and non-severe type of COVID-19.
Methods Clinical data about 95 COVID-19 inpatients in Beijing YouAn Hospital, Capital Medical University from January 21, 2020 to February 24, 2020 were analyzed retrospectively. Of the 95 cases, 57 cases were in non-severe group (mild and common), and 38 cases were in severe group (severe and critically severe), the differences in clinical characteristics and prognosis between the two groups were analyzed.
Results The median age of severe patients was 66 years, which was significantly higher than the median age of non-severe patients (43 years) (P < 0.001). More severe patients had shortness of breath (78.95% vs 19.30%, P < 0.001), hypertension (50.00% vs 11.76%, P < 0.001) and coronary heart disease (21.05% vs 5.26%, P=0.019), with significant difference. Compared with those in non-severe group, the lymphocyte count of severe patients was significantly lower, while the levels of C-reactive protein (CRP), procalcitonin (PCT), lactic acid (LA), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), myoglobin (MYO) and troponin I (TNI) were significantly higher (all P < 0.05). Compared with the levels on admission, the CRP and LA levels in severe group further increased with the progressing of the disease, while the lymphocyte count decreased (P < 0.05, respectively). All the death occurred in the severe group with the mortality rate of 18.42%.
Conclusion Patients with older age and suffering from hypertension and coronary heart disease are susceptible to severe type of COVID-19. In the course of disease progression in severe patients, the lymphocyte count decreases, while the levels of C-reactive protein and lactic acid increase progressively, which might play early warning roles. Compared with non-severe patients, severe patients have more obvious inflammatory response and are more prone to have myocardial injury, which is one of the causes of death.
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