A Controllable Inflammatory Response and Temporary Abnormal Coagulation in Moderate Disease of COVID-19 in Wuhan, China

Abstract

Background: The coronavirus disease 2019 (COVID-19) is now a worldwide challenge for public health. Among 7 million patients, about 80% present mild to moderate disease, but studies dedicate to these patients are actually scarce. The aim of our study is to clarify the characteristics of laboratory test index of COVID-19 patient with moderate symptoms during the first wave of the pandemic in Wuhan, China.

Methods: In this retrospective cohort study, we included 107 adult inpatients with confirmed moderate disease of COVID-19 from the Affiliated Hospital of Jianghan University during February and early March 2020. All of these patients were recovered from COVID-19 and discharged from hospital. Demographic, clinical, and laboratory data of admission and discharge were extracted from electronic medical records and analyzed using SPSS, as well as among young, middle age and elderly people.

Results: The median age of this cohort of patients was 56.0 years. And the median hospitalization time was 16 days. Common clinical manifestations included fever, cough, asthenia and shortness of breath. On admission, laboratory results showed normal or increased neutrophil ratio, low lymphocyte count, decreased hemoglobin level, and increased inflammatory indicators (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)); and some patients were complicated with coagulation disorder and myocardial damage. Furthermore, patients older than 60 years had statistically higher CRP, ESR and fibrinogen level. As the health condition was improved at discharge, the median level of most laboratory results were in the normal range except hemoglobin and related blood cell count, as well as inflammatory indicator ESR. And patients older than 60 years showed slower recovery on coagulation parameters when compared to younger patients.

Conclusions: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection induces a controllable inflammatory response in moderate disease of COVID-19 in Wuhan, China. Since patients older than 60 years had higher inflammatory state and more dysregulated coagulation condition, it might be essential to closely assess their illness.

J Clin Med Res. 2020;12(9):590-597
doi: https://doi.org/10.14740/jocmr4293