Abstract
Background: Coronavirus Disease 2019 (COVID-19) is threatening billions of people. We described the clinical characteristics and explore virological and immunological factors associated with clinical outcomes.
Methods: 297 COVID-19 patients hospitalized in Guangzhou Eighth People’s Hospital between January 20 and February 20, 2020 were included. Epidemiological, clinical and laboratory data were collected and analyzed. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in respiratory tract, blood samples and digestive tract was detected and lymphocyte subsets were tested periodically.
Result: Among the 297 patients (median age of 48 years), 154 (51.9 %) were female, 245 (82.5 %) mild/moderate cases, and 52 (17.5 %) severe/critical cases. 270 patients were detected for SARS-CoV-2 RNA in anal swabs and/or blood samples, and the overall positive rate was 23.0 % (62/270), higher in severe/critical cases than in mild/moderate cases (52.0 % vs. 16.4 %, P < 0.001). The CD4/CD8 ratio on admission was significantly higher in severe/critical cases than in mild/moderate cases (1.84 vs. 1.50, P = 0.022). During a median follow-up period of 17 days, 36 (12.1 %) patients were admitted to intensive care unit (ICU), 16 (5.4 %) patients developed respiratory failure and underwent mechanical ventilation, four (1.3 %) patients needed extracorporeal membrane oxygenation (ECMO), only one (0.34 %) patients died of multiple organ failure. Detectable SARS-CoV-2 RNA in anal swabs and/or blood samples, as well as higher CD4/CD8 ratio were independent risk factors of respiratory failure and ICU admission.
Conclusions: Most of COVID-19 patients in Guangzhou are mild/moderate, and presence of extrapulmonary virus and higher CD4/CD8 ratio are associated with higher risk of worse outcomes.
Keywords: CD4/CD8 ratio; COVID-19; Extrapulmonary; ICU admission; Respiratory failure; SARS-CoV-2; Virus.
【저자키워드】 COVID-19, SARS-CoV-2, Respiratory failure, virus, ICU admission, CD4/CD8 ratio, Extrapulmonary, 【초록키워드】 coronavirus disease, severe acute respiratory syndrome coronavirus 2, Coronavirus disease 2019, coronavirus, Hospitalized, Respiratory failure, intensive care, mechanical ventilation, Clinical characteristics, Lymphocyte subsets, severe acute respiratory syndrome Coronavirus, virus, coronavirus 2, clinical outcomes, ICU, RNA, outcomes, Severe acute respiratory syndrome, lymphocyte, extracorporeal membrane oxygenation, Lymphocyte subset, female, Patient, ICU admission, ECMO, SARS-CoV-2 RNA, anal swab, respiratory tract, multiple organ failure, respiratory, anal swabs, Admission, positive rate, Blood, COVID-19 patient, Guangzhou, Extrapulmonary, Organ failure, on admission, digestive tract, acute respiratory syndrome, Factor, Virological, follow-up period, higher risk, Blood samples, median age, independent risk factors, laboratory data, blood sample, independent risk factor, CD4/CD8, MOST, immunological, tested, described, analyzed, collected, median, significantly higher, patients died, 【제목키워드】 Clinical outcome, Patient, Factor, Guangzhou, China,