Analysis of the risk factors of the common type evolving into severe type COVID-19

Objective To investigate the clinical risk factors of common type evolving into severe type corona virus disease 2019 (COVID-19).

Methods The clinical data of 24 patients with common type evolving into severe type COVID-19 were collected(evolution group), the clinical characteristics, blood test results, inflammatory indexes, chest CT imaging characteristics and antiviral treatment were analyzed, which was compared with the clinical data of 41 patients with common type COVID-19 patients(common type group).The possible risk factors of COVID-19 patients developing from common type to severe type were analyzed.

Results For the clinical characteristics between evolution group and common type group, the differences of the complication with underlying disease and respiratory rate were statistically significant(P<0.05), and the differences of the sex, age and clinical symptoms were not statistically significant(P>0.05).The results of blood test showed that the lymphocyte counts and plasma albumin level in evolution group were significantly lower than those in common type group(P<0.05), the blood glucose and urea levels in evolution group were significantly higher than those in common type group(P<0.05), and the differences of the white blood cell count, platelet count and alanine aminotransferase levels between two groups were not statistically significant(P>0.05).The inflammatory indexes in evolution group were significantly higher than that in common type group(P<0.05).The double lung ground glass shadow, patchy shadow and consolidation shadow, double lung with diffuse ground glass shadow complicated with bronchogram were the mainly imaging findings of the common type group, and the common type patients with two lung large area consolidation shadow complicated with pulmonary interstitial change were more likely to develop to severe type.The differences of the clinical effects of two and three kinds of drugs treatment between two groups were not statistically significant(P>0.05).

Conclusions The combination of underlying diseases, respiratory frequency, lymphocyte count, blood glucose, albumin, urea level, inflammatory factors and imaging manifestations are the possible risk factors of common type evolving into severe type COVID-19.