3.1 Distinct characteristics of patients with different disease severity and clinical outcomes
A total of 289 patients with COVID-19 were included in this study. Until 28th Mar. 2020, all 78 (27.0%) severe patients and 162 (56.0%) non-severe patients were discharged from the two hospitals, and 49 (17.0%) patients were non-survived. Demographic, clinical symptomatic and radiological characteristics of these patients on admission were shown in Table 1-3.
Compared with the survived severe patients (group B in Table 1-3), non-survived patients (group A in Table 1-3) were older in age (p =0.029) and had higher prevalence of symptoms including chest tightness/dyspnea (p = 0.002), gastrointestinal symptoms manifested as loss of appetite (p = 0.015), higher neutrophil counts (p = 0.004) and percentages (p = 0.016), higher lymphocyte percentages (p = 0.014), larger NLR (p = 0.045), higher monocyte percentages (p = 0.006), higher levels of C-reactive protein (p < 0.001), procalcitonin (p= 0.002), D-dimer (p = 0.005), ALT (p = 0.023), BUN (p = 0.003) and serum creatinine (p = 0.028). Increased neutrophil percentages (p = 0.007), PCT (p = 0.002), D-dimer (p = 0.005), and BUN (p = 0.001), as well as decreased eosinophil percentages (p = 0.003) were more commonly observed in non-survived patients (Table 1-3).
In comparison to survived severe patients (group B), non-severe patients (group C in Table 1-3) were relatively younger (p < 0.001) and had less exposure history (p < 0.001), less underlying comorbidities (p < 0.001), less surgery history (p = 0.004) and gastrointestinal symptoms (p = 0.011). Leucocyte and neutrophil counts, and NLR were lower in non-severe patients than in survived severe patients. Also, lower serum levels of CRP, PCT, D-dimer, CK-MB, ALT, AST and BUN were observed in non-severe patients (Fig. 1, Table 1-3). Lymphopenia, thrombocytopenia and elevated biochemical parameters including liver and renal function-related markers (all p <0.001) were found in significantly low or normal levels in non-severe patients (Table 1-3).
Radiologically, ground-glass opacity [99 (46.3%)] and subpleural lesions [103 (48.1%)] were common CT signs and distributed in different numbers of lobes (Fig. S1). Also, non-severe patients had higher proportion of normal chest CT images or fewer infected pulmonary lobes, compared to survived severe patients (p = 0.01). As expected, dramatic differences of these clinical characteristics, laboratory findings and CT imaging changes between non-survived patients and non-severe patients were found (Table 1-3).