3.1 Coinfection and severe underlying disease
All 186 patients were divided into two groups, namely, the COVID-19 only group and COVID-19 + severe underlying disease or other respiratory pathogen infections group, as shown in Table 1.
Table 1. Comparison between COVID-19 only group and COVID-19 + severe underlying disease or other respiratory pathogen infections group
Groups-No., %
|
All patients
(n=186)
|
Disease severity
|
|
Outcome
|
|
No-severe (n=123)
|
Severe
(n=63)
|
P1
|
Survival
(n=166)
|
Death
(n=20)
|
P2
|
COVID-19 only (n=134)
|
134/186 (66.1)
|
100/123 (81.3)
|
34/63 (54.0)
|
<0.001
|
128/166 (77.1)
|
6/20 (30.0)
|
<0.001
|
|
|
100/134 (74.6)
|
34/134 (25.4)
|
|
128/134 (95.5)
|
6/134 (4.5)
|
|
COVID-19 + severe underlying disease or other respiratory pathogen infections (n=52)
|
52/186 (33.9)
|
23/123 (18.7)
|
29/63 (46.0)
|
|
38/166 (22.9)
|
14/20 (70.0)
|
|
|
|
23/52 (44.2)
|
29/52 (55.8)
|
|
38/52 (73.1)
|
14/52 (26.9)
|
|
P values denote comparison between included cases and excluded cases.
In the COVID-19 only group, 25.4% of the patients had severe cases, and 4.5% of the patients died. In the COVID-19 + severe underlying disease or other respiratory pathogen infections group, 55.8% of the patients had severe cases, and 26.9% of the patients died. (P1<0.001, P2<0.001)
Obviously, coinfection and severe underlying disease were related to severe COVID-19 and an outcome of death.
3.2 Demographic and clinical characteristics
The demographic and clinical characteristics are presented in Table 2, summarizing 134 cases.
Table 2. Clinical characteristics of 134 patients with COVID-19
|
All patients
(n=134)
|
Disease severity
|
|
Outcome
|
|
No-severe (n=100)
|
Severe
(n=34)
|
P1
|
Survival
(n=128)
|
Death
(n=6)
|
P2
|
Age, Median (range)-years
|
49.0 (38.7-57.2)
|
48.5 (38.0-57.0)
|
51.0 (39.0-59.7)
|
0.292
|
49.0 (38.2-57.0)
|
66.0 (38.2-76.7)
|
0.078
|
Age groups-No., %
|
|
|
|
0.332
|
|
|
0.006
|
<30years (n=16)
|
16/134 (11.9)
|
14/100 (14.0)
|
2/34 (5.9)
|
|
16/128 (12.5)
|
0/6 (0.0)
|
|
|
|
14/16 (87.5)
|
2/16 (12.5)
|
|
16/16 (100.0)
|
0/16 (0.0)
|
|
30-60 years (n=94)
|
94/134 (70.1)
|
70/100 (70.0)
|
24/34 (70.6)
|
|
92/128 (71.9)
|
2/6 (33.3)
|
|
|
|
70/94 (74.5)
|
24/94 (25.5)
|
|
92/94 (97.9)
|
2/94 (2.1)
|
|
>60 years (n=24)
|
24/134 (17.9)
|
16/100(16.0)
|
8/34 (23.5)
|
|
20/128 (15.6)
|
4/6 (66.7)
|
|
|
|
16/24 (66.7)
|
8/24 (33.3)
|
|
20/24 (83.3)
|
4/24 (16.7)
|
|
Sex -No., %
|
|
|
|
0.549
|
|
|
0.034
|
Female (n=59)
|
59/134 (44.0)
|
46/100 (46.0)
|
13/34 (38.2)
|
|
59/128 (46.1)
|
0/6 (0.0)
|
|
|
|
46/59 (78.0)
|
13/59 (22.0)
|
|
59/59 (100.0)
|
0/59 (0.0)
|
|
Male (n=75)
|
75/134 (56.0)
|
54/100 (54.0)
|
21/34 (61.8)
|
|
69/128 (53.9)
|
6/6 (100.0)
|
|
|
|
54/75 (72.0)
|
21/75 (28.0)
|
|
69/75 (92.0)
|
6/75 (8.0)
|
|
Symptoms
|
|
|
|
|
|
|
Fever -No., %
|
|
|
0.014
|
|
|
0.343
|
With (n=106)
|
106/134 (79.1)
|
74/100 (74.0)
|
32/34 (94.1)
|
|
100/128 (78.1)
|
6/6 (100.0)
|
|
|
|
74/106 (69.8)
|
32/106 (30.2)
|
|
100/106 (94.3)
|
6/106 (5.7)
|
|
Without (n=28)
|
28/134 (20.9)
|
26/100 (0.26)
|
2/34 (5.9)
|
|
28/128 (21.9)
|
0/6 (0.0)
|
|
|
|
26/28 (92.9)
|
2/28 (7.1)
|
|
28/28 (100.0)
|
0/28 (0.0)
|
|
Highest temperature, median (range) - ℃
|
37.9 (37.1-38.8)
|
39.0 (38.1-39.5)
|
<0.001
|
38.0 (37.2-39.0)
|
39.0 (38.9-39.1)
|
0.036
|
Highest temperature during hospitalization-No., %
|
|
|
0.001
|
|
|
0.023
|
≤ 37 ℃ (n=26)
|
26/134 (19.4)
|
24/100 (24.0)
|
2/34 (5.9)
|
|
26/128 (20.3)
|
0/6 (0.0)
|
|
|
|
24/26 (92.3)
|
2/26 (7.7)
|
|
26/26 (100.0)
|
0/26 (0.0)
|
|
37-38 ℃ (n=39)
|
39/134 (29.1)
|
33/100 (33.0)
|
6/34 (17.6)
|
|
39/128 (30.5)
|
0/6 (0.0)
|
|
|
|
33/39 (84.6)
|
6/39 (15.4)
|
|
39/39 (100.0)
|
0/39 (0.0)
|
|
38-39 ℃ (n=30)
|
30/134 (22.4)
|
23/100 (23.0)
|
7/34 (20.6)
|
|
29/128 (22.7)
|
1/6 (16.7)
|
|
|
|
23/30 (76.7)
|
7/30 (23.3)
|
|
29/30 (96.7)
|
1/30 (3.3)
|
|
≥ 39 ℃ (n=39)
|
39/134 (29.1)
|
20/100 (20.0)
|
19/34 (55.9)
|
|
34/128 (26.6)
|
5/6 (83.3)
|
|
|
|
20/39 (51.3)
|
19/39 (48.7)
|
|
34/39 (87.2)
|
5/39 (12.8)
|
|
Cough-No., %
|
|
|
|
0.032
|
|
|
0.337
|
With (n=104)
|
104/134 (77.6)
|
73/100 (73.0)
|
31/34 (91.2)
|
|
98/128 (76.6)
|
6/6 (100.0)
|
|
|
|
73/104 (70.2)
|
31/104 (29.8)
|
|
98/104 (94.2)
|
6/104 (5.8)
|
|
Without (n=30)
|
30/134 (22.4)
|
27/100 (27.0)
|
3/34 (8.8)
|
|
30/128 (23.4)
|
0/6 (0.0)
|
|
|
|
27/30 (90.0)
|
3/30 (10.0)
|
|
30/30 (100.0)
|
0/6 (0.0)
|
|
Chest tightness -No., %
|
|
|
|
<0.001
|
|
|
0.006
|
With (n=59)
|
59/134 (44.0)
|
31/100 (31.0)
|
28/34 (82.4)
|
|
53/128 (41.4)
|
6/6 (100.0)
|
|
|
|
31/59 (52.5)
|
28/59 (47.5)
|
|
53/59 (89.8)
|
6/59 (10.2)
|
|
Without (n=75)
|
75/134 (56.0)
|
69/100 (69.0)
|
6/34 (17.6)
|
|
75/128 (58.6)
|
0/6 (0.0)
|
|
|
|
69/75 (92.0)
|
6/75 (8.0)
|
|
75/75 (100.0)
|
0/75 (0.0)
|
|
Headaches-No., %
|
|
|
|
<0.001
|
|
|
0.019
|
With (n=15)
|
15/134 (11.2)
|
5/100 (5.0)
|
10/34 (29.4)
|
|
12/128 (9.4)
|
3/6 (50.0)
|
|
|
|
5/15 (33.3)
|
10/15 (66.7)
|
|
12/15 (80.0)
|
3/15 (20.0)
|
|
Without (n=119)
|
119/134 (88.8)
|
95/100 (95.0)
|
24/34 (70.6)
|
|
116/128 (90.6)
|
3/6 (50.0)
|
|
|
|
95/119 (79.8)
|
24/119 (20.2)
|
|
116/119 (97.5)
|
3/119 (2.5)
|
|
Fatigue -No., %
|
|
|
|
<0.001
|
|
|
0.081
|
With (n=81)
|
81/134 (60.4)
|
49/100 (49.0)
|
32/34 (94.1)
|
|
75/128 (58.6)
|
6/6 (100.0)
|
|
|
|
49/81 (60.5)
|
32/81 (39.5)
|
|
75/81 (92.6)
|
6/81 (7.4)
|
|
Without (n=53)
|
53/134 (39.6)
|
51/100 (51.0)
|
2/34 (5.9)
|
|
53/128 (41.4)
|
0/6 (0.0)
|
|
|
|
51/53 (96.2)
|
2/53 (3.8)
|
|
53/53 (100.0)
|
0/53 (0.0)
|
|
Diarrhea-No., %
|
|
|
|
0.418
|
|
|
1.000
|
With (n=8)
|
8/134 (6.0)
|
5/100 (5.0)
|
3/34 (8.8)
|
|
8/128 (6.3)
|
0/6 (0.0)
|
|
|
|
5/8 (62.5)
|
3/8 (37.5)
|
|
8/8 (100.0)
|
0/8 (0.0)
|
|
Without (n=126)
|
126/134 (94.0)
|
95/100 (95.0)
|
31/34 (91.2)
|
|
120/128 (93.7)
|
6/6 (100.0)
|
|
|
|
95/126 (75.4)
|
31/126 (24.6)
|
|
120/126 (95.2)
|
6/126 (4.8)
|
|
P1 values denote comparison between nonsevere and severe cases
P2 values denote comparison between survivors and nonsurvivors
3.2.1 Age
We grouped the patients into three groups according to age, as indicated in Table 2.
For the <30 years group, 12.5% of the patients had severe disease, and none of the patients died. For the 30-60 years group, 25.5% had severe disease, and 2.1% died. In the >60 years group, severe disease developed in 33.3% of the patients, and 16.7% died. (P1=0.332, P2=0.006)
Thus, age >60 years was related to an outcome of death.
3.2.2 Sex
As depicted in Table 2, 44.0% of the patients were female and 56.0% male.
In the female group, 22.0% of the patients developed a severe case, though none of the patients died. For the male group, 28.0% had severe cases, and 8.0% died. (P1=0.549, P2=0.034)
Overall, male sex was related to an outcome of death.
3.2.3 Fever
The data in Table 2 show that 79.1% of the patients had a fever.
In total, 30.2% of the patients in the fever group had a severe case of COVID-19, and 5.7% of the patients died. Among those without fever, 7.1% had severe disease, and none of the patients died. (P1=0.014, P2=0.343)
Fever group was found to be related to severe COVID-19.
3.2.4 Temperature
As shown in Table 2, we grouped patients into four groups according to their highest temperature during hospitalization.
COVID-19 severity and mortality according to temperature was recorded as follows: 7.7% and none in the ≤37℃ group; 15.4% and none in the 37-38℃ group; 23.3% and 3.3% in the 38-39℃ group; and 48.7% and 12.8% in the ≥ 39℃ group, respectively. (P1=0.001, P2=0.023)
These data show that a higher temperature was related to severe COVID-19 and an outcome of death.
3.2.5 Cough
Table 2 shows that 77.6% of the patients had a cough.
For those with cough group, 29.8% of the patients had a severe case, and 5.8% died. For those without cough, 10.0% had severe illness, and none died. (P1=0.032, P2=0.337)
Clearly, cough was related to severe COVID-19.
3.2.6 Chest tightness
As shown in Table 2, 44.0% of the patients had chest tightness.
In total, 47.5% of the patients in the chest tightness group had severe cases, with 10.2% mortality; 8.0% of the patients without chest tightness had severe cases, and none of them died. (P1<0.001, P2=0.006)
Chest tightness was related to severe COVID-19 disease and death.
3.2.7 Headaches
As shown in Table 2, 11.2% of the patients experienced headaches.
Among those with headaches, 66.7% were severe cases, and 20.0% of the patients died. For those without headaches, 20.2% were severe cases, and 2.5% died. (P1<0.001, P2=0.019)
This study found headache to be related to severe COVID-19 and death.
3.2.8 Fatigue
In total, 60.4% of the patients had fatigue (Table 2).
Severe cases comprised 39.5% of the fatigue group, with 7.4% dying, and 3.8% of the without fatigue group, with no deaths. (P1<0.001, P2=0.081)
Fatigue was related to severe COVID-19.
3.2.9 Diarrhea
As described in Table 2, 6.0% of the patients had diarrhea.
A total of 37.5% of the patients with the diarrhea had severe COVID-19, though none died; 24.6% of the patients without diarrhea had severe disease, and 4.8% died.
In this case, the P values were greater than 0.05 (P1=0.418, P2=1.000); thus, studies with the same conditions and larger samples are needed.
3.3 Laboratory findings
The laboratory findings are provided in Tables 3 and 4.
Table 3. Laboratory findings for 134 patients with COVID-19
Laboratory findings
|
All patients
(n=134)
|
Disease severity
|
Outcome
|
|
No-severe
(n=100)
|
Severe
(n=34)
|
P1
|
Survival
(n=128)
|
Death
(n=6)
|
P2
|
Highest blood leukocyte count during hospitalization-No., %
|
|
|
<0.001
|
|
|
<0.001
|
>10*10^9/L (n=27)
|
27/134 (20.1)
|
2/100 (2.0)
|
25/34 (73.5)
|
|
21/128 (16.4)
|
6/6 (100.0)
|
|
|
|
2/27 (7.4)
|
25/27 (92.6)
|
|
21/27 (77.8)
|
6/27 (22.2)
|
|
4-10*10^9/L (n=93)
|
93/134 (69.4)
|
86/100 (86.0)
|
7/34 (20.6)
|
|
93/128 (72.7)
|
0/6 (0.0)
|
|
|
|
86/93 (92.5)
|
7/93 (7.5)
|
|
93/93 (100.0)
|
0/93 (0.0)
|
|
< 4*10^9/L (n=14)
|
14/134 (10.4)
|
12/100 (12.0)
|
2/34 (5.9)
|
|
14/128 (10.9)
|
0/6 (0.0)
|
|
|
|
12/14 (85.7)
|
2/14 (14.3)
|
|
14/14 (100.0)
|
0/14 (0.0)
|
|
Highest neutrophil count during hospitalization-No., %
|
|
|
<0.001
|
|
|
<0.001
|
>7*10^9/L (n=31)
|
31/134 (23.1)
|
5/100 (5.0)
|
26/34 (76.5)
|
|
25/128 (19.5)
|
6/6 (100.0)
|
|
|
|
5/31 (16.1)
|
26/31 (83.9)
|
|
25/31 (80.6)
|
6/31 (19.4)
|
|
2-7*10^9/L (n=94)
|
94/134 (70.1)
|
86/100 (86.0)
|
8/34 (23.5)
|
|
94/128 (73.4)
|
0/6 (0.0)
|
|
|
|
86/94 (91.5)
|
8/94 (8.5)
|
|
94/94 (100.0)
|
0/94 (0.0)
|
|
< 2*10^9/L (n=9)
|
9/134 (6.7)
|
9/100 (9.0)
|
0/34 (0.0)
|
|
9/128 (7.0)
|
0/6 (0.0)
|
|
|
|
9/9 (100.0)
|
0/9 (0.0)
|
|
9/9 (100.0)
|
0/9 (0.0)
|
|
Lowest lymphocyte count during hospitalization-No., %
|
|
|
<0.001
|
|
|
0.006
|
<0.4* 10^9/L (n=15)
|
15/134 (11.2)
|
3/100 (3.0)
|
12/34 (35.3)
|
|
12/128(9.4)
|
3/6 (50.0)
|
|
|
|
3/15 (20.0)
|
12/15 (80.0)
|
|
12/15 (80.0)
|
3/15 (20.0)
|
|
0.4-0.8*10^9/L (n=46)
|
46/134 (34.3)
|
30/100 (30.0)
|
16/34 (47.1)
|
|
44/128 (34.4)
|
2/6 (33.3)
|
|
|
|
30/46 (65.2)
|
16/46 (34.8)
|
|
44/46 (95.7)
|
2/46 (4.3)
|
|
>0.8*10^9/L (n=73)
|
73/134 (54.5)
|
67/100 (67.0)
|
6/34 (17.6)
|
|
72/128 (56.3)
|
1/6 (16.7)
|
|
|
|
67/73 (91.8)
|
6/73 (8.2)
|
|
72/73 (98.6)
|
1/73 (1.4)
|
|
Highest C-reactive protein level during hospitalization-No., %
|
|
|
<0.001
|
|
|
<0.001
|
<20 mg/L (n=57)
|
57/134 (42.5)
|
56/100 (56.0)
|
1/34 (2.9)
|
|
57/128 (44.5)
|
0/6 (0.0)
|
|
|
|
56/57 (98.2)
|
1/57 (1.8)
|
|
57/57 (100.0)
|
0/57 (0.0)
|
|
20-90 mg/L (n=38)
|
38/134 (28.4)
|
32/100 (32.0)
|
6/34 (17.6)
|
|
38/128 (29.7)
|
0/6 (0.0)
|
|
|
|
32/38 (84.2)
|
6/38 (15.8)
|
|
38/38 (100.0)
|
0/38 (0.0)
|
|
90-150 mg/L (n=16)
|
16/134 (11.9)
|
9/100 (9.0)
|
7/34 (20.6)
|
|
16/128 (12.5)
|
0/6 (0.0)
|
|
|
|
9/16 (56.3)
|
7/16 (43.8)
|
|
16/16 (100.0)
|
0/16 (0.0)
|
|
>150 mg/L (n=23)
|
23/134 (17.2)
|
3/100 (3.0)
|
20/34 (58.8)
|
|
17/128 (13.3)
|
6/6 (100.0)
|
|
|
|
3/23 (13.0)
|
20/23 (87.0)
|
|
17/23 (73.9)
|
6/23 (26.1)
|
|
Highest D-dimer level during hospitalization-No., %
|
|
|
<0.001
|
|
|
<0.001
|
≤1 mg/L (n=98)
|
98/134 (73.1)
|
90/100 (90.0)
|
8/34 (23.5)
|
|
98/128 (76.6)
|
0/6 (0.0)
|
|
|
|
90/98 (91.8)
|
8/98 (8.2)
|
|
98/98 (100.0)
|
0/98 (0.0)
|
|
>1 mg/L (n=36)
|
36/134 (26.9)
|
10/100 (10.0)
|
26/34 (76.5)
|
|
30/128 (23.4)
|
6/6 (100.0)
|
|
|
|
10/36 (27.8)
|
26/36 (72.2)
|
|
30/36 (83.3)
|
6/36 (16.7)
|
|
Highest alanine aminotransferase activity during hospitalization-No., %
|
|
<0.001
|
|
|
0.295
|
<40 U/L (n=77)
|
77/134 (57.5)
|
71/100 (71.0)
|
6/34 (17.6)
|
|
75/128 (58.6)
|
2/6 (33.3)
|
|
|
|
71/77 (92.2)
|
6/77 (7.8)
|
|
75/77 (97.4)
|
2/77 (2.6)
|
|
40-80 U/L (n=32)
|
32/134 (23.9)
|
18/100 (18.0)
|
14/34 (41.2)
|
|
29/128 (22.7)
|
3/6 (50.0)
|
|
|
|
18/32 (56.3)
|
14/32 (43.7)
|
|
29/32 (90.6)
|
3/32 (9.4)
|
|
>80 U/L (n=25)
|
25/134 (18.7)
|
11/100 (11.0)
|
14/34 (41.2)
|
|
24/128 (18.8)
|
1/6 (16.7)
|
|
|
|
11/25 (44.0)
|
14/25 (56.0)
|
|
24/25 (96.0)
|
1/25 (4.0)
|
|
Highest aspartate aminotransferase activity during hospitalization-No., %
|
|
<0.001
|
|
|
0.003
|
<40 U/L (n=86)
|
86/134 (64.2)
|
77/100 (77.0)
|
9/34 (26.5)
|
|
86/128 (67.2)
|
0/6 (0.0)
|
|
|
|
77/86 (89.5)
|
9/86 (10.5)
|
|
86/86 (100.0)
|
0/86 (0.0)
|
|
40-80 U/L (n=37)
|
37/134 (27.6)
|
19/100 (19.0)
|
18/34 (52.9)
|
|
32/128 (25.0)
|
5/6 (83.3)
|
|
|
|
19/37 (51.4)
|
18/37 (48.6)
|
|
32/37 (86.5)
|
5/37 (13.5)
|
|
>80 U/L (n=11)
|
11/134 (8.2)
|
4/100 (4.0)
|
7/34 (20.6)
|
|
10/128 (7.8)
|
1/6 (16.7)
|
|
|
|
4/11 (36.4)
|
7/11 (63.6)
|
|
10/11 (90.9)
|
1/11 (9.1)
|
|
Highest Creatinine level during hospitalization-No., %
|
|
|
0.314
|
|
|
0.070
|
≤ 90 μmol/L (n=110)
|
110/134 (82.1)
|
84/100 (84.0)
|
26/34 (76.5)
|
|
107/128 (83.6)
|
3/6 (50.0)
|
|
|
|
84/110 (76.4)
|
26/110 (23.6)
|
|
107/110 (97.3)
|
3/110 (2.7)
|
|
>90 μmol/L (n=24)
|
24/134 (17.9)
|
16/100 (16.0)
|
8/34 (23.5)
|
|
21/128 (16.4)
|
3/6 (50.0)
|
|
|
|
16/24 (66.7)
|
8/24 (33.3)
|
|
21/24 (87.5)
|
3/24 (12.5)
|
|
Highest α - hydroxybutyrate dehydrogenase activity during hospitalization-No., %
|
<0.001
|
|
|
<0.001
|
<183 U/L (n=30)
|
30/134 (22.4)
|
30/100 (30.0)
|
0/34 (0.0)
|
|
30/128 (23.4)
|
0/6 (0.0)
|
|
|
|
30/30 (100.0)
|
0/30 (0.0)
|
|
30/30 (100.0)
|
0/30 (0.0)
|
|
183-360 U/L (n=64)
|
64/134 (47.8)
|
53/100 (53.0)
|
11/34 (32.4)
|
|
64/128 (50.0)
|
0/6 (0.0)
|
|
|
|
53/64 (82.8)
|
11/64 (17.2)
|
|
64/64 (100.0)
|
0/64 (0.0)
|
|
360-540 U/L (n=31)
|
31/134 (23.1)
|
17/100 (17.0)
|
14/34 (41.2)
|
|
31/128 (24.2)
|
0/6 (0.0)
|
|
|
|
17/31 (54.8)
|
14/31 (45.2)
|
|
31/31 (100.0)
|
0/31 (0.0)
|
|
>540 U/L (n=9)
|
9/134 (6.7)
|
0/100 (0.0)
|
9/34 (26.5)
|
|
3/128 (2.3)
|
6/6 (100.0)
|
|
|
|
0/9 (0.0)
|
9/9 (100.0)
|
|
3/9 (33.3)
|
6/9 (66.7)
|
|
Highest lactate dehydrogenase activity during hospitalization-No., %
|
|
<0.001
|
|
|
<0.001
|
<245 U/L (n=52)
|
52/134 (38.8)
|
51/100 (51.0)
|
1/34 (2.9)
|
|
52/128 (40.6)
|
0/6 (0.0)
|
|
|
|
51/52 (98.1)
|
1/52 (1.9)
|
|
52/52 (100.0)
|
0/52 (0.0)
|
|
245-480 U/L (n=64)
|
64/134 (47.8)
|
44/100 (44.0)
|
20/34 (58.8)
|
|
64/128 (50.0)
|
0/6 (0.0)
|
|
|
|
44/64 (68.8)
|
20/64 (31.2)
|
|
64/64 (100.0)
|
0/64 (0.0)
|
|
480-720 U/L (n=12)
|
12/134 (9.0)
|
5/100 (5.0)
|
7/34 (20.6)
|
|
11/128 (8.6)
|
1/6 (16.7)
|
|
|
|
5/12 (41.7)
|
7/12 (58.3)
|
|
11/12 (91.7)
|
1/12 (8.3)
|
|
>720 U/L (n=6)
|
6/134 (4.5)
|
0/100 (0.0)
|
6/34 (17.6)
|
|
1/128 (0.8)
|
5/6 (83.3)
|
|
|
|
0/6 (0.0)
|
6/6 (100.0)
|
|
1/6 (16.7)
|
5/6 (83.3)
|
|
Highest creatine kinase activity during hospitalization-No., %
|
|
|
0.032
|
|
|
0.031
|
<200 U/L (n=101)
|
101/134 (75.4)
|
81/100 (81.0)
|
20/34 (58.8)
|
|
99/128 (77.3)
|
2/6 (33.3)
|
|
|
|
81/101 (80.2)
|
20/101 (19.8)
|
|
99/101 (98.0)
|
2/101 (2.0)
|
|
200-400U/L (n=13)
|
13/134 (9.7)
|
8/100 (8.0)
|
5/34 (14.7)
|
|
12/128 (9.4)
|
1/6 (16.7)
|
|
|
|
8/13 (61.5)
|
5/13 (38.5)
|
|
12/13 (92.3)
|
1/13 (7.7)
|
|
>400 U/L (n=20)
|
20/134 (14.9)
|
11/100 (11.0)
|
9/34 (26.5)
|
|
17/128 (13.3)
|
3/6 (50.0)
|
|
|
|
11/20 (55.0)
|
9/20 (45.0)
|
|
17/20 (85.0)
|
3/20 (15.0)
|
|
P1 values denote comparison between nonsevere and severe cases
P2 values denote comparison between survivors and nonsurvivors
Table 4. Laboratory findings for 134 patients with COVID-19
Laboratory findings
|
All patients
(n=134)
|
Disease severity
|
Outcome
|
|
No-severe
(n=100)
|
Severe
(n=34)
|
P1
|
Survival
(n=128)
|
Death
(n=6)
|
P2
|
Blood leukocyte count on admission, No., %
|
|
|
<0.001
|
|
|
0.001
|
>10*10^9/L (n=11)
|
11/134 (8.2)
|
1/100 (1.0)
|
10/34 (14.7)
|
|
8/128 (6.3)
|
3/6 (50.0)
|
|
|
|
1/11 (9.1)
|
10/11 (90.9)
|
|
8/11 (72.7)
|
3/11 (27.3)
|
|
4-10*10^9/L (n=94)
|
94/134 (70.1)
|
75/100 (75.0)
|
19/34 (55.9)
|
|
91/128 (71.1)
|
3/6 (50.0)
|
|
|
|
75/94 (79.8)
|
19/94 (20.2)
|
|
91/94 (96.8)
|
3/94 (3.2)
|
|
< 4*10^9/L (n=29)
|
29/134 (21.6)
|
24/100 (24.0)
|
5/34 (29.4)
|
|
29/128 (22.7)
|
0/6 (0.0)
|
|
|
|
24/29 (82.8)
|
5/29 (17.2)
|
|
29/29 (100.0)
|
0/29 (0.0)
|
|
Neutrophil count on admission-No., %
|
|
|
<0.001
|
|
|
<0.001
|
>7*10^9/L (n=18)
|
18/134 (13.4)
|
2/100 (2.0)
|
16/34 (47.1)
|
|
14/128 (10.9)
|
4/6 (66.7)
|
|
|
|
2/18 (11.1)
|
16/18 (88.9)
|
|
14/18 (77.8)
|
4/18 (22.2)
|
|
2-7*10^9/L (n=94)
|
94/134 (70.1)
|
79/100 (79.0)
|
15/34 (44.1)
|
|
92/128 (71.9)
|
2/6 (33.3)
|
|
|
|
79/94 (84.0)
|
15/94 (16.0)
|
|
92/94 (97.9)
|
2/94 (2.1)
|
|
< 2*10^9/L (n=22)
|
22/134 (16.4)
|
19/100 (19.0)
|
3/34 (8.8)
|
|
22/128 (17.2)
|
0/6 (0.0)
|
|
|
|
19/22 (86.4)
|
3/22 (13.6)
|
|
22/22 (100.0)
|
0/22 (0.0)
|
|
Lymphocyte count on admission-No., %
|
|
|
<0.001
|
|
|
<0.001
|
<0.4* 0^9/L (n=4)
|
4/134 (3.0)
|
0/100 (0.0)
|
4/34 (11.8)
|
|
2/128 (1.6)
|
2/6 (33.3)
|
|
|
|
0/4 (0.0)
|
4/4 (100.0)
|
|
2/4 (50.0)
|
2/4 (50.0)
|
|
0.4-0.8*10^9/L (n=36)
|
36/134 (26.9)
|
23/100 (23.0)
|
13/34 (38.2)
|
|
35/128 (27.3)
|
1/6 (16.7)
|
|
|
|
23/36 (63.9)
|
13/36 (36.1)
|
|
35/36 (97.2)
|
1/36 (2.8)
|
|
>0.8*10^9/L (n=94)
|
94/134 (70.1)
|
77/100 (77.0)
|
17/34 (50.0)
|
|
91/128 (71.1)
|
3/6 (50.0)
|
|
|
|
77/94 (81.9)
|
17/94 (18.1)
|
|
91/94 (96.8)
|
3/94 (3.2)
|
|
C-reactive protein level on admission-No., %
|
|
|
<0.001
|
|
|
0.009
|
<20 mg/L (n=68)
|
68/134 (50.7)
|
65/100 (65.0)
|
3/34 (8.8)
|
|
68/128 (53.1)
|
0/6 (0.0)
|
|
|
|
65/68 (95.6)
|
3/68 (4.4)
|
|
68/68 (100.0)
|
0/68 (0.0)
|
|
20-90 mg/L (n=42)
|
42/134 (31.3)
|
28/100 (28.0)
|
14/34 (41.2)
|
|
40/128 (31.3)
|
2/6 (33.3)
|
|
|
|
28/42 (66.7)
|
14/42 (33.3)
|
|
40/42 (95.2)
|
2/42 (4.8)
|
|
90-150 mg/L (n=11)
|
11/134 (8.2)
|
4/100 (4.0)
|
7/34 (20.6)
|
|
9/128 (7.0)
|
2/6 (33.3)
|
|
|
|
4/11 (36.4)
|
7/11 (63.6)
|
|
9/11 (81.8)
|
2/11 (18.2)
|
|
>150 mg/L (n=13)
|
13/134 (9.7)
|
3/100 (3.0)
|
10/34 (29.4)
|
|
11/128 (8.6)
|
2/6 (33.3)
|
|
|
|
3/13 (23.1)
|
10/13 (76.9)
|
|
11/13 (84.6)
|
2/13 (15.4)
|
|
D-dimer level on admission-No., %
|
|
|
<0.001
|
|
|
0.037
|
≤1 mg/L (n=115)
|
115/134 (85.8)
|
95/100 (95.0)
|
20/34 (58.8)
|
|
112/128 (87.5)
|
3/6 (50.0)
|
|
|
|
95/115 (82.6)
|
20/115 (17.4)
|
|
112/115 (97.4)
|
3/115 (2.6)
|
|
>1 mg/L (n=19)
|
19/134 (14.2)
|
5/100 (5.0)
|
14/34 (41.2)
|
|
16/128 (12.5)
|
3/6 (50.0)
|
|
|
|
5/19 (26.3)
|
14/19 (73.7)
|
|
16/19 (84.2)
|
3/19 (15.8)
|
|
Alanine aminotransferase activity on admission-No., %
|
|
<0.001
|
|
|
0.032
|
<40 U/L (n=97)
|
97/134 (72.4)
|
81/100 (81.0)
|
16/34 (47.1)
|
|
95/128 (74.2)
|
2/6 (33.3)
|
|
|
|
81/97 (83.5)
|
16/97 (16.5)
|
|
95/97 (97.9)
|
2/97 (2.1)
|
|
40-80 U/L (n=33)
|
33/134 (24.6)
|
18/100 (18.0)
|
15/34 (44.1)
|
|
30/128 (23.4)
|
3/6 (50.0)
|
|
|
|
18/33 (54.5)
|
15/33 (45.5)
|
|
30/33 (90.9)
|
3/33 (9.1)
|
|
>80 U/L (n=4)
|
4/134 (3.0)
|
1/100 (1.0)
|
3/34 (8.8)
|
|
3/128 (2.3)
|
1/6 (16.7)
|
|
|
|
1/4 (25.0)
|
3/4 (75.0)
|
|
3/4 (75.0)
|
1/4 (25.0)
|
|
Aspartate aminotransferase activity on admission-No., %
|
|
<0.001
|
|
|
0.004
|
<40 U/L (n=99)
|
99/134 (73.9)
|
83/100 (83.0)
|
16/34 (47.1)
|
|
98/128 (76.6)
|
1/6 (16.7)
|
|
|
|
83/99 (83.8)
|
16/99 (16.2)
|
|
98/99 (99.0)
|
1/99 (1.0)
|
|
40-80 U/L (n=30)
|
30/134 (22.4)
|
15/100 (15.0)
|
15/34 (44.1)
|
|
26/128 (20.3)
|
4/6 (66.7)
|
|
|
|
15/30 (50.0)
|
15/30 (50.0)
|
|
26/30 (86.7)
|
4/30 (3.3)
|
|
>80 U/L (n=5)
|
5/134 (3.7)
|
2/100 (2.0)
|
3/34 (8.8)
|
|
4/128 (3.1)
|
1/6 (16.7)
|
|
|
|
2/5 (40.0)
|
3/5 (60.0)
|
|
4/5 (80.0)
|
1/5 (20.0)
|
|
Creatinine level on admission-No., %
|
|
|
1.000
|
|
|
1.000
|
≤ 90 μmol/L (n=130)
|
130/134 (97.0)
|
97/100 (97.0)
|
33/34 (97.1)
|
|
124/128 (96.9)
|
6/6 (100.0)
|
|
|
|
97/130 (74.6)
|
33/130 (25.4)
|
|
124/130 (95.4)
|
6/130 (4.6)
|
|
>90 μmol/L (n=4)
|
4/134 (3.0)
|
3/100 (3.0)
|
1/34 (2.9)
|
|
4/128 (3.1)
|
0/6 (0.0)
|
|
|
|
3/4 (75.0)
|
1/4 (25.0)
|
|
4/4 (100.0)
|
0/4 (0.0)
|
|
α - hydroxybutyrate dehydrogenase activity on admission-No., %
|
<0.001
|
|
|
<0.001
|
<183 U/L (n=40)
|
40/134 (29.9)
|
40/100 (40.0)
|
0/34 (0.0)
|
|
40/128 (31.3)
|
0/6 (0.0)
|
|
|
|
40/40 (100.0)
|
0/40 (0.0)
|
|
40/40 (100.0)
|
0/40 (0.0)
|
|
183-360 U/L (n=67)
|
67/134 (50.0)
|
49/100 (49.0)
|
18/34 (52.9)
|
|
65/128 (50.8)
|
2/6 (33.3)
|
|
|
|
49/67 (73.1)
|
18/67 (26.9)
|
|
65/67 (97.0)
|
2/67 (3.0)
|
|
360-540 U/L (n=25)
|
25/134 (18.7)
|
11/100 (11.0)
|
14/34 (41.2)
|
|
23/128 (18.0)
|
2/6 (33.3)
|
|
|
|
11/25 (44.0)
|
14/25 (56.0)
|
|
23/25 (92.0)
|
2/25 (8.0)
|
|
>540 U/L (n=2)
|
2/134 (1.5)
|
0/100 (0.0)
|
2/34 (5.9)
|
|
0/128 (0.0)
|
2/6 (33.3)
|
|
|
|
0/2 (0.0)
|
2/2 (100.0)
|
|
0/2 (0.0)
|
2/2 (100.0)
|
|
Lactate dehydrogenase activity on admission-No., %
|
|
<0.001
|
|
|
<0.001
|
<245 U/L (n=64)
|
64/134 (47.8)
|
62/100 (62.0)
|
2/34 (5.9)
|
|
63/128 (49.2)
|
1/6 (16.7)
|
|
|
|
62/64 (96.9)
|
2/64 (3.1)
|
|
63/64 (98.4)
|
1/64 (1.6)
|
|
245-480 U/L (n=57)
|
51/134 (42.5)
|
34/100 (34.0)
|
23/34 (67.6)
|
|
56/128 (43.8)
|
1/6 (16.7)
|
|
|
|
34/57 (59.6)
|
23/57 (40.4)
|
|
56/57 (98.2)
|
1/57 (1.8)
|
|
480-720 U/L (n=11)
|
11/134 (8.2)
|
4/100 (4.0)
|
7/34 (20.6)
|
|
9/128 (7.0)
|
2/6 (33.3)
|
|
|
|
4/11 (36.4)
|
7/11 (63.6)
|
|
9/11 (81.8)
|
2/11 (18.2)
|
|
>720 U/L (n=2)
|
2/134 (1.5)
|
0/100 (0.0)
|
2/34 (5.9)
|
|
0/128 (0.0)
|
2/6 (33.3)
|
|
|
|
0/2 (0.0)
|
2/2 (100.0)
|
|
0/2 (0.0)
|
2/2 (100.0)
|
|
Creatine kinase activity on admission-No., %
|
|
|
0.020
|
|
|
0.010
|
<200 U/L (n=108)
|
108/134 (80.6)
|
86/100 (86.0)
|
22/34 (64.7)
|
|
106/128 (82.8)
|
2/6 (33.3)
|
|
|
|
86/108 (79.6)
|
22/108 (20.4)
|
|
106/108 (98.1)
|
2/108 (1.9)
|
|
200-400U/L (n=8)
|
8/134 (6.0)
|
5/100 (5.0)
|
3/34 (8.8)
|
|
7/128 (5.5)
|
1/6 (16.7)
|
|
|
|
5/8 (62.5)
|
3/8 (37.5)
|
|
7/8 (87.5)
|
1/8 (12.5)
|
|
>400 U/L (n=18)
|
18/134 (13.4)
|
9/100 (9.0)
|
9/34 (26.5)
|
|
15/128 (11.7)
|
3/6 (50.0)
|
|
|
|
9/18 (50.0)
|
9/18 (50.0)
|
|
15/18 (83.3)
|
3/18 (16.7)
|
|
P1 values denote comparison between nonsevere and severe cases
P2 values denote comparison between survivors and nonsurvivors
3.3.1 Blood leukocyte count
3.3.1.1 Highest blood leukocyte count during hospitalization
As shown in Table 3, we divided patients into three groups according to their highest blood leukocyte count during hospitalization.
The results were as follows: for the >10*10^9/L group, 92.6% of the patients had severe cases, and 22.2% of them died; for the 4-10*10^9/L group, 7.5% of the patients had severe cases, and none of them died; for the <4*10^9/L group, 14.3% of the patients had severe cases, and none of them died. (P1<0.001, P2<0.001)
A blood leukocyte count of >10*10^9/L during hospitalization was strongly related to severe COVID-19 and an outcome of death.
3.3.1.2 Blood leukocyte count on admission
Table 4 divides patients into three groups according to their blood leukocyte count on admission.
The data for severe COVID-19 and death were as follows: for the >10*10^9/L group, 90.9% and 27.3%; for the 4-10*10^9/L group, 20.2% and 3.2%; for the < 4*10^9/L group, 17.2% and none, respectively. (P1<0.001, P2<0.001)
A blood leukocyte count of >10*10^9/L on admission was strongly associated with severe disease and death.
3.3.2 Neutrophils
3.3.2.1 Highest neutrophil count during hospitalization
As shown in Table 3, we grouped patients into three groups according to their highest neutrophil count during hospitalization.
The data for severe COVID-19 and death were as follows: for the >7*10^9/L group, 83.9% and 19.4%; for the 2-7*10^9/L group, 8.5% and none; for the < 2*10^9/L group, none and none, respectively. (P1<0.001, P2<0.001)
A blood neutrophil count >7*10^9/L during hospitalization was strongly related to severe COVID-19 and death.
3.3.2.2 Neutrophil count on admission
As shown in Table 4, we grouped patients into three groups according to their neutrophil count on admission.
The data for severe COVID-19 and death were as follows: for the >7*10^9/L group, 88.9% and 22.2%; for the 2-7*10^9/L group, 16.0% and 2.1%; for the <2*10^9/L group, 13.6% and none, respectively. (P1<0.001, P2<0.001)
A blood neutrophil count >7*10^9/L on admission was strongly related to severe COVID-19 and an outcome of death.
3.3.3 Lymphocytes
3.3.3.1 Lowest lymphocyte count during hospitalization
We also divided patients into three groups according to their lowest lymphocyte count during hospitalization (Table 3).
The results were as follows: for the <0.4*10^9/L group, 80.0% of the patients had severe disease, and 20.0% died; for the 0.4-0.8*10^9/L group, 34.8% of the patients had severe disease, and 4.3% died; For the >0.8*10^9/L group, 8.2% of the patients had severe disease, and 1.4% died. (P1<0.001, P2<0.001)
A lower lymphocyte count during hospitalization was strongly linked to severe COVID-19 and an outcome of death.
3.3.3.2 Lymphocyte count on admission
As shown in Table 4, we grouped patients according to their lymphocyte count on admission.
The data for severe COVID-19 and death were as follows: for the <0.4*10^9/L group, all and 50.0%; for the 0.4-0.8*10^9/L group, 36.1% and 2.8%; for the >0.8* 10^9/L group, 18.1% and 3.2%, respectively. (P1<0.001, P2<0.001)
A lower lymphocyte count on admission was strongly related to severe COVID-19 and death.
3.3.4 C-reactive protein level
3.3.4.1 Highest C-reactive protein level during hospitalization
As presented in Table 3, we grouped patients into four groups according to their highest C-reactive protein level during hospitalization.
The data for severe COVID-19 and death were as follows: for the <20 mg/L group, 1.8% and none; for the 20-90 mg/L group, 15.8% and none; for the 90-150 mg/L group, 43.8% and none; for the >150 mg/L group, 87.0% and 26.1%, respectively. (P1<0.001, P2<0.001)
Higher C-reactive protein levels during hospitalization were strongly related to severe COVID-19 and an outcome of death.
3.3.4.2 C-reactive protein level on admission
We also classified patients into four groups according to their C-reactive protein level on admission (Table 4).
The data for severe COVID-19 and death were as follows: for the <20 mg/L group, 4.4% and none; for the 20-90 mg/L group, 33.3% and 4.8%; for the 90-150 mg/L group, 63.6% and 18.2%; for the >150 mg/L group, 76.9% and 15.4%, respectively. (P1<0.001, P2=0.009)
Higher C-reactive protein levels on admission were strongly associated with severe COVID-19.
3.3.5 D-dimer level
3.3.5.1 Highest D-dimer level during hospitalization
As shown in Table 3, we grouped patients according to their highest D-dimer level during hospitalization.
For the ≤1 mg/L group, 8.2% of the patients had severe cases, and none of the patients died. For the >1 mg/L group, 72.2% of the patients had severe cases, and 16.7% died. (P1<0.001, P2<0.001)
A higher D-dimer level was strongly linked to severe COVID-19 and an outcome of death.
3.3.5.2 D-dimer level on admission
We also grouped patients into two groups according to their D-dimer level on admission (Table 4).
For the ≤1 mg/L group, 17.4% of the patients had severe illness, and 2.6% of died. For the >1 mg/L group, 73.7% had severe disease, and 15.8% of the patients died. (P1<0.001, P2=0.037)
A higher D-dimer level on admission was strongly related to severe COVID-19 and an outcome of death.
3.3.6 Alanine aminotransferase activity
3.3.6.1 Highest alanine aminotransferase activity during hospitalization
As shown in Table 3, we grouped patients according to their highest alanine aminotransferase activity during hospitalization.
For the <40 U/L group, 7.8% of the patients had severe cases, and 2.6% of them died. For the 40-80 U/L group, 43.7% had severe cases, and 9.4% died. For the >80 U/L group, 56.0% had severe cases, and 4.0% died. (P1<0.001, P2=0.295)
Higher alanine aminotransferase activity during hospitalization was associated with severe COVID-19.
3.3.6.2 Alanine aminotransferase activity on admission
Table 4 groups patients into three groups according to their alanine aminotransferase activity on admission.
The data for severe COVID-19 and death were as follows: for the <40 U/L group, 16.5% and 2.1%; for the 40-80 U/L group, 45.5% and 9.1%; For the >80 U/L group, 75.0% and 25.0%, respectively. (P1<0.001, P2=0.032)
Higher alanine aminotransferase activity on admission was related to severe COVID-19 and an outcome of death.
3.3.7 Aspartate aminotransferase activity
3.3.7.1 Highest aspartate aminotransferase activity during hospitalization
As shown in Table 3, we grouped patients into three groups according to their highest aspartate aminotransferase activity during hospitalization.
The data for severe COVID-19 and death were as follows; for the <40 U/L group, 10.5% and none; for the 40-80 U/L group, 48.6% and 13.5%; for the >80 U/L group, 63.6% and 9.1%, respectively. (P1<0.001, P2=0.003)
Higher aspartate aminotransferase activity during hospitalization was also linked to severe COVID-19.
3.3.7.2 Aspartate aminotransferase activity on admission
As shown in Table 4, we grouped patients into three groups according to their aspartate aminotransferase activity on admission.
The data for severe COVID-19 and death were as follows: for the <40 U/L group, 16.2% and 1.0%; for the 40-80 U/L group, 50.0% and 3.3%; for the >80 U/L group, 60.0% and 20.0%, respectively. (P1<0.001, P2=0.004)
Higher aspartate aminotransferase activity on admission was related to severe COVID-19 and an outcome of death.
3.3.8 Creatinine level
3.3.8.1 Highest creatinine level during hospitalization
Patients were classified according to their highest creatinine level during hospitalization (Table 3).
The results were as follows: for the ≤90 μmol/L group, 23.6% of the patients had severe illness, and 2.7% died; for the >90 μmol/L group, 33.3% had severe disease, and 12.5% died.
However, the P values were greater than 0.05 (P1=0.314, P2=0.07), and studies with larger samples under the same conditions are needed in the future.
3.3.8.2 Creatinine level on admission
As shown in Table 4, we grouped patients into according to their creatinine level on admission.
The results were as follows: for the ≤90 μmol/L group, 25.4% of the patients had severe cases, and 4.6% of the patients died; for the >90 μmol/L group, 25.0% had severe cases, and none died.
As above, the P values were greater than 0.05 (P1=1.000, P2=1.000), and thus studies with larger samples under the same conditions are needed.
3.3.9 α-Hydroxybutyrate dehydrogenase activity
3.3.9.1 Highest α-hydroxybutyrate dehydrogenase activity during hospitalization
Table 3 groups patients according to their highest α-hydroxybutyrate dehydrogenase activity during hospitalization.
The data for severe COVID-19 and death were as follows: for the <183 U/L group, none and none; for the 183-360 U/L group, 17.2% and none; for the 360-540 U/L group, 45.2% and none; for the >540 U/L group, all and 66.7%, respectively. (P1<0.001, P2<0.001)
Higher α-hydroxybutyrate dehydrogenase activity during hospitalization was related to severe COVID-19 and an outcome of death.
3.3.10α-Hydroxybutyrate dehydrogenase activity on admission
As shown in Table 4, we grouped patients into four groups according to their α-hydroxybutyrate dehydrogenase activity on admission.
The data for severe COVID-19 and death were as follows: for the <183 U/L group, none and none; for the 183-360 U/L group, 26.9% and 3.0%; for the 360-540 U/L group, 56.0% and 8.0%; for the >540 U/L group, all and all, respectively. (P1<0.001, P2<0.001)
Higher α-hydroxybutyrate dehydrogenase activity on admission was associated with severe COVID-19 and an outcome of death.
3.3.11 Lactate dehydrogenase activity
3.3.11.1 Highest lactate dehydrogenase activity during hospitalization
As indicated in Table 3, we grouped patients according to their highest lactate dehydrogenase activity during hospitalization.
The data for severe COVID-19 and death were as follows: for the <245 U/L group, 1.9% and none; for the 245-480 U/L group, 31.2% and none; for the 480-720 U/L group, 58.3% and 8.3%; for the >720 U/L group, all and 83.3%, respectively. (P1<0.001, P2<0.001)
Higher lactate dehydrogenase activity during hospitalization was related to severe COVID-19 and an outcome of death.
3.3.11.2 Lactate dehydrogenase activity on admission
As shown in Table 4, we grouped patients into four groups according to their lactate dehydrogenase activity on admission.
The data for severe COVID-19 and death were as follows: for the <245 U/L group, 3.1% and 1.6%; for the 245-480 U/L group, 40.4% and 1.8%; for the 480-720 U/L group, 63.6% and 18.2%; for the >720 U/L group, all and all, respectively. (P1<0.001, P2<0.001)
Higher lactate dehydrogenase activity on admission was found to be related to severe COVID-19 and death.
3.3.12 Creatine kinase activity
3.3.12.1 Highest creatine kinase activity during hospitalization
In Table 3, patients are classified into three groups according to their highest creatine kinase activity during hospitalization.
For the <200 U/L group, 19.8% of the patients had severe cases, and 2.0% of the patients died. For the 200-400 U/L group, 38.5% of the patients had severe illness, and 7.7% died. For the >400 U/L group, 45.0% of the patients developed severe disease, and 15.0% died. (P1=0.032, P2=0.031)
Higher creatine kinase activity during hospitalization was related to severe COVID-19 and an outcome of death.
3.3.12.2 Creatine kinase activity on admission
As shown in Table 4, we also grouped patients according to their creatine kinase activity on admission.
The data for severe COVID-19 and death were as follows: for the <200 U/L group, 20.4% and 1.9%; for the 200-400 U/L group, 37.5% and 12.5%; for the >400 U/L group, 50.0% and 16.7%, respectively. (P1=0.020, P2=0.010)
Higher creatine kinase activity on admission was linked to severe COVID-19 and death.
3.4 Administration of gamma globulin
Administration of gamma globulin was not used as a conventional therapy method and depended on the wish of the patients and their relatives.
There were 34 severe cases that divided into two groups according to whether gamma globulin was used (Table 5).
Table 5. Therapy of 34 patients with severe COVID-19
Groups-No., %
|
All of the severe cases
(n=34)
|
Outcomes
|
|
Survival
(n=28)
|
Death
(n=6)
|
P
|
Severe cases treated with gamma globulin (n=16)
|
16/34 (47.1)
|
15/28 (53.6)
|
1/6 (16.7)
|
0.180
|
|
|
15/16 (93.8)
|
1/16 (6.2)
|
|
Severe cases treated without gamma globulin (n=18)
|
18/34 (52.9)
|
13/28 (46.4)
|
5/6 (83.3)
|
|
|
|
13/18 (72.2)
|
5/18 (27.8)
|
|
P values denote comparison between survivors and nonsurvivors
For severe cases treated with gamma globulin, 93.8% of the patients survived, and 6.2% died. Among severe cases not treated with gamma globulin, 72.2% survived, and27.8% died.
It appears that administration of gamma globulin was helpful for reducing mortality among severe cases. However, the P value was greater than 0.05 (P=0.180), and future studies under the same conditions with larger samples are needed.