Clinical Predictors of Severity Based on an Analysis of Data of COVID-19 Pneumonia

Background: COVID-19 pneumonia is still spreading with an increasing number of confirmed cases around the world. We aimed to characterize the chest CT and laboratory features of hospitalized patients with intensive care unit (ICU) and non-ICU COVID-19 infection, and develop risk index for COVID-19 patients with ICU admission. Methods: In this retrospective cohort study, we included all the confirmed COVID-19 patients hospitalized in our hospital from January 17 to March 3, 2020. Demographic, clinical, laboratory, radiological and clinical outcome data were collected from the hospital information system, nursing records and laboratory reports. Findings: 144 confirmed COVID-19 patients were recruited with median age of 57 years (IQR 44-58). Common symptoms at onset of most infected patients were fever (128[88.89%]) and cough (115[79.86%]; 32 patients were admission to ICU, and 112 patients were discharge. Compared with non-ICU patients, ICU patients were presented with higher levels of leukocyte, neutrophil count, procalcitonin, hypersensitive C-reactive protein and erythrocyte sedimentation, chest CT score while lower serum lymphocyte counts. Binary logistic regression analysis showed that serum neutrophil counts (OR=5.094, 95% CI 1.907, 13.61), hs-CRP (OR=3.004, 95% CI 1.147, 9.54) and chest CT score (OR=0.176, 95% CI 0.053, 0.589) were positively associated with ICU admission. Interpretation: These clinical characteristics may be a useful and conventional tool for quickly establishing a COVID-19 hierarchical management system, particularly, semi-quantitative CT assessment and serum neutrophil counts, hs-CRP level could be risk predictor of severity COVID-19 pneumonia with ICU admission. Funding Statement: This research was supported by the projects from the National Scientific Foundation of China (No. 81901715, 31630025 and 81930045).Declaration of Interests: All authors declare no conflicts of interests.Ethics Approval Statement: The retrospectively study was approved by the institutional review board of our hospital and written informed consent was waived.