The coronavirus disease 2019 (COVID-19) has been spreading worldwide. Severe cases quickly progressed with unfavorable outcomes. We aim to investigate the clinical features of COVID-19 and identify the risk factors associated with its progression. Data of confirmed SARS-CoV-2-infected patients and healthy participants were collected. Thirty-seven healthy people and 79 confirmed patients, which include 48 severe patients and 31 mild patients, were recruited. COVID-19 patients presented with dysregulated immune response (decreased T, B, and NK cells and increased inflammatory cytokines). Also, they were found to have increased levels of white blood cell, neutrophil count, and D-dimer in severe cases. Moreover, lymphocyte, CD4 + T cell, CD8 + T cell, NK cell, and B cell counts were lower in the severe group. Multivariate logistic regression analysis showed that CD4 + cell count, neutrophil-to-lymphocyte ratio (NLR) and D-dimer were risk factors for severe cases. Both CT score and clinical pulmonary infection score (CPIS) were associated with disease severity. The receiver operating characteristic (ROC) curve analysis has shown that all these parameters and scores had quite a high predictive value. Immune dysfunction plays critical roles in disease progression. Early and constant surveillance of complete blood cell count, T lymphocyte subsets, coagulation function, CT scan and CPIS was recommended for early screening of severe cases.
【저자키워드】 immunology, Medical research, Risk factors, Microbiology, Diseases, 【초록키워드】 COVID-19, coronavirus disease, disease severity, NK cell, D-dimer, progression, risk factor, CD4, CD8, Neutrophil-to-lymphocyte ratio, B cell, outcomes, Disease progression, lymphocyte, T cell, ROC, White blood cell, Surveillance, CT scan, severe cases, Inflammatory cytokines, Severe patient, characteristic, Critical, patients, clinical feature, mild patients, Pulmonary infection, NLR, Analysis, COVID-19 patient, blood cell count, Predictive, dysfunction, Logistic regression analysis, severe group, neutrophil count, multivariate, T lymphocyte, participant, dysregulated immune response, cell count, coagulation function, parameter, Complete, shown, identify, collected, include, healthy, recruited, progressed, SARS-CoV-2-infected patient, 【제목키워드】 COVID-19, Severe patient, dysfunction,