The clinical warning index of severe COVID-19: discussion based on the clinical features and outcomes of 4 patients

Y.-S. Song, Y.-B. Hao, H.-T. Liu, L.-H. Li, Z.-Z. Yang, W.-W. Liu, Q. Liu, S.-S. Zhang, T.-L. Fan

Zhengzhou People’s Hospital, Zhengzhou, Henan, China. fantianli@zzu.edu.cn

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• Infectious Diseases

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is spreading worldwide. The onset of severe COVID-19 could lead to multiple organ damage and even death. It is worth paying attention to the warning index of the onset for severe COVID-19 so that patients can be identified and monitored carefully.

PATIENTS AND METHODS: The report is a retrospective study that describes and analyzes the clinical features during the treatment of COVID-19. Four patients with COVID-19 were involved in this study, who were father-and-son pairs from two families. All patients were treated with the same combination of anti-microbial and anti-viral agents for 10-14 days, adjusting for the disease status. The primary outcome measure was SARS-CoV-2 detection using RT-qPCR with oropharyngeal swabs. Chest CT imaging served as a secondary outcome measure.

RESULTS: One of the four patients progressed to severe disease, while the remaining patients recovered with the same treatment. A persistent decrease in the lymphocyte ratio and increase in the C-reactive protein (CRP) level were observed in the severe patient, along with other typical symptoms of COVID-19.

CONCLUSIONS: The cases we described indicate that blood cell and CRP tests could be useful risk warnings of severe onset of COVID-19.

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