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

Eur Rev Med Pharmacol Sci. 2021 Feb;25(3):1732-1737. doi: 10.26355/eurrev_202102_24883.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • C-Reactive Protein / analysis
  • COVID-19 / blood
  • COVID-19 / diagnosis*
  • COVID-19 / diagnostic imaging
  • COVID-19 Drug Treatment*
  • COVID-19 Nucleic Acid Testing
  • Humans
  • Lung / diagnostic imaging
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2*
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antiviral Agents
  • C-Reactive Protein