A Multi-center Study of COVID-19 with Multivariate Prognostic Analysis

  1. Wen Zeng
  2. Xin Feng
  3. Jie Huang
  4. Chuan Du
  5. Dongming Qu
  6. Xiang Zhang
  7. Jianquan Zhang

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Abstract

Purpose

Coronavirus disease (COVID-19) pandemic is now a global health concern. However, there is no detailed analysis of the factors related to patients’ improvement.

Patients and methods

We compared the clinical characteristics, laboratory findings, CT images, and treatment of COVID-19 patients from two different cities in China. One hundred and sixty-nine patients were recruited from January 27 to March 17, 2020 at five hospitals in Hubei and Guangxi. They were divided into four groups according to age and into two groups according to presence of comorbidities. Multivariate statistical analyses were performed for the prognosis of the disease.

Results

Fifty-two patients (30.8%) had comorbidities, and the percentage of critical COVID-19was higher in the comorbidities group (11.6%vs.0.9%, p<0.05). Older patients had higher proportion of severe or critical disease. The results showed that lymphocyte count was significantly associated with the number of days from positive COVID-19 nucleic acid test to negative test; number of days from onset of symptoms to confirmation of diagnosis was significantly associated with the time it took for symptoms to improve; and number of days from onset of symptoms to confirmation of diagnosis and disease severity were significantly associated with chest computed tomography improvement.

Conclusions

Age, comorbidities, lymphocyte count, and SpO 2 may predict the risk of severity of COVID-19. Early isolation, early diagnosis, and early initiation of management can slow down the progression and spread of COVID-19.

Key Points

Age and comorbidities can predict the risk of severity of COVID-19, Lymphocyte count and SpO 2 may predict the risk of severity of COVID-19. Early isolation, Early diagnosis can slow down the progression of COVID-19

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  1. ScreenIT

    SciScore for 10.1101/2020.09.26.20202234: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: All patients enrolled in this study were diagnosed with COVID-19 according to the diagnostic criteria from the Chinese Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment(7th edition), which was produced by the National Health Commission of China.7 The study was approved by the Research Ethics Commission of Guangxi Medical University First Affiliated Hospital approval number: 2020(KY-E-06).
    Randomizationnot detected.
    BlindingTwo attending radiologists were invited to interpret all chest CT scans independently, and they were blinded to the clinical information of each patient.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All data analyses were carried out using IBM Statistical Package for the Social Sciences for Windows, version 25 (SPSS Inc., Chicago, Illinois), and graphs were created using GraphPad Prism 7.0 software (GraphPad Software Inc., San Diego, CA, USA).
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The present study has some limitations. First, due to the limited number of cases, some results need to be further validated with more patients. Second, the effect of antiviral agents and corticosteroidson COVID-19 needs further validation. Prospective studies should be performed to get more accurate results. Third, because this was a retrospective analysis, the time of CT imaging and nucleic acid test was not standardized and unified, t may have reduced the accuracy of the result. More cases need to be analyzed to obtain more information.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.09.26.20202234v1 on medRxiv