J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 12, Number 9, September 2020, pages 590-597

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

Figure 1. Illustration of percentage changes of laboratory index according to number of patients. Data are presented as number of patients that had changed level in laboratory assessments. (a) Decreased lymphocyte count on admission and at discharge. (b) Decreased hemoglobin level on admission and at discharge. (c) Increased CRP level on admission and at discharge. (d) Increased ESR level on admission and at discharge. (e) Increased fibrinogen level on admission and at discharge. (f) Increased D-dimer level on admission and at discharge. (g) Increased FDP level on admission and at discharge. In for the data collected on admission, out for data collected at discharge. CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; FDP: fibrinogen degradation product.

**Table 1.** Demographics and Clinical Characteristics of Patients on Admission (N = 107)
Data are median (IQR), n (%), or n/N (%). IQR: interquartile range; SpO₂: oxygen saturation.
Age (median (IQR), year)	56 (43.5 - 65.0)
Sex
Female	62 (58%)
Male	45 (42%)
Hospitalization days (median (IQR), day)	16 (13 - 20.5)
Medical history
Hypertension	31 (29%)
Diabetes	6 (5.6%)
Heart disease	10 (9.3%)
Cancer	3 (2.8%)
Other respiratory disease	6 (5.6%)
Kidney disease	6 (5.6%)
Liver disease	6 (5.6%)
Neurological disease	1 (0.9%)
Thyroid disease	2 (1.9%)
Others	8 (7.5%)
Symptoms
Fever	84 (78.5%)
Cough	63 (58.9%)
Sputum production	18 (16.8%)
Nose obstruction, rhinorrhea	2 (1.9%)
Shortness of breath	32 (29.9%)
Headache	5 (4.7%)
Chest pain	2 (1.9%)
Myalgia	10 (9.3%)
Asthenia	35 (32.7%)
Vomiting	3 (2.8%)
Diarrhea	12 (11.2%)
Signs
Respiratory rate (median (IQR), bpm)	23 (21 - 30)
Heart rate (median (IQR), bpm)	88 (82.5 - 98)
Systolic pressure > 140mm Hg	18 (17%)
SpO₂ ≤ 93%	27 (25%)

Table 1. Demographics and Clinical Characteristics of Patients on Admission (N = 107)

Data are median (IQR), n (%), or n/N (%). IQR: interquartile range; SpO₂: oxygen saturation.

Age (median (IQR), year)

56 (43.5 - 65.0)

Sex

Female

62 (58%)

Male

45 (42%)

Hospitalization days (median (IQR), day)

16 (13 - 20.5)

Medical history

Hypertension

31 (29%)

Diabetes

6 (5.6%)

Heart disease

10 (9.3%)

Cancer

3 (2.8%)

Other respiratory disease

6 (5.6%)

Kidney disease

6 (5.6%)

Liver disease

6 (5.6%)

Neurological disease

1 (0.9%)

Thyroid disease

2 (1.9%)

Others

8 (7.5%)

Symptoms

Fever

84 (78.5%)

Cough

63 (58.9%)

Sputum production

18 (16.8%)

Nose obstruction, rhinorrhea

2 (1.9%)

Shortness of breath

32 (29.9%)

Headache

5 (4.7%)

Chest pain

2 (1.9%)

Myalgia

10 (9.3%)

Asthenia

35 (32.7%)

Vomiting

3 (2.8%)

Diarrhea

12 (11.2%)

Signs

Respiratory rate (median (IQR), bpm)

23 (21 - 30)

Heart rate (median (IQR), bpm)

88 (82.5 - 98)

Systolic pressure > 140mm Hg

18 (17%)

SpO₂ ≤ 93%

27 (25%)

**Table 2.** Summary of Laboratory Findings on Admission and at Discharge
Laboratory index	Normal range	Results on admission	Results at discharge
Data are median (IQR) or n/N (%). ^aThe normal level of NT-proBNP is increased with age. Three normal ranges for different age groups are listed, and results are presented accordingly. ↑For increased blood level. ↓For decreased blood level. hsCRP: high sensitive C-reactive protein; ESR: erythrocyte sedimentation rate; FDP: fibrinogen degradation product; NT-proBNP: N-terminal prohormone brain natriuretic peptide; hs-cTnL: high sensitive cardiac troponin L; CK: creatine kinase; LDH: lactose dehydrogenase; IQR: interquartile range; NA: not applicable.
Neutrophil count, × 10⁹/L	1.8 - 6.3	3.4 (2.5 - 4.2)	8%↑	3.1 (2.5 - 3.8)	4%↑
			12%↓		6%↓
Neutrophil ratio, %	40.0 - 75.0	67.7 (60.1 - 75.8)	26%↑	62.0 (56.4 - 66.6)	3%↑
Lymphocyte count, × 10⁹/L	1.1 - 3.2	1.0 (0.8 - 1.4)	56%↓	1.4 (1.1 - 1.7)	23%↓
Lymphocyte ratio, %	20.0 - 50.0	22.1 (16.4 - 29.7)	39%↓	26.8 (22.9 - 31.9)	13%↓
Red blood cell count, × 10¹²/L			51%↓		52%↓
Female	3.8 - 5.1	3.8 (3.5 - 4.2)		3.8 (3.4 - 4.0)
Male	4.3 - 5.8	4.2 (3.9 - 4.5)		4.1 (3.8 - 4.6)
Hemoglobin, g/L			49%↓		46%↓
Female	115.0 - 150.0	113 (103 - 127)		112 (101.5 - 120)
Male	130.0 - 175.0	131 (123 - 144)		128.5 (119.0 - 138.3)
Hematocrit, %			56%↓		55%↓
Female	35.0 - 45.0	34.3 (32.2 - 38.3)		34.1 (31.5 - 36.8)
Male	40.0 - 50.0	39.4 (36.1 - 43.2)		38.3 (35.6 - 41.5)
Platelet count, × 10⁹/L	125.0 - 350.0	226.0 (168.5 - 313.0)	15%↑	221 (178.0 - 275.8)	8%↑
			7%↓		3%↓
hsCRP, mg/L	0 - 8.0	16.3 (2.9 - 62.7)	60%↑	1.7 (1.1 - 5.8)	21%↑
ESR, mm/h	0 - 20.0	64.0 (34.0 - 94.5)	89%↑	50.0 (24.0 - 80.0)	86%↑
D-dimer, mg/L	0 - 1.0	0.4 (0.3 - 0.8)	20%↑	0.3 (0.2 - 0.5)	7 %↑
Fibrinogen, g/L	2.0 - 4.0	4.1 (2.9 - 4.7)	51%↑	2.9 (2.4 - 3.3)	9%↑
FDP, mg/L	0 - 3.0	2.6 (1.6 - 4.1)	41%↑	1.9 (1.5 - 3.1)	27%↑
NT-proBNP^a, pg/mL			10%↑		2%↑
< 50 years	0 - 450.0	120.0 (65.0 - 244.6)		82.8 (54.3 - 162.8)
50 - 75 years	0 - 900.0	296.5 (110.4 - 552.5)		186.3 (119.5 - 351.8)
> 75 years	0 - 1,800.0	1,287.8 (611.1 - 1,467.7)		365.7 (288.1 - 430.6)
hs-cTnL, ng/mL	0 - 0.1	0.001 (0.001 - 0.004)	0↑	NA	NA
CK, U/L	20.0 - 190.0	64.0 (33.5 - 125.0)	16%↑	45.0 (31.0 - 57.3)	0↑
LDH, U/L	114.0 - 240.0	228.0 (182.0 - 284.5)	46%↑	175.5 (152.5 - 217.8)	15%↑

Table 2. Summary of Laboratory Findings on Admission and at Discharge

Laboratory index

Normal range

Results on admission

Results at discharge

Median (IQR)

Patient (%)

Median (IQR)

Patient (%)

Data are median (IQR) or n/N (%). ^aThe normal level of NT-proBNP is increased with age. Three normal ranges for different age groups are listed, and results are presented accordingly. ↑For increased blood level. ↓For decreased blood level. hsCRP: high sensitive C-reactive protein; ESR: erythrocyte sedimentation rate; FDP: fibrinogen degradation product; NT-proBNP: N-terminal prohormone brain natriuretic peptide; hs-cTnL: high sensitive cardiac troponin L; CK: creatine kinase; LDH: lactose dehydrogenase; IQR: interquartile range; NA: not applicable.

Neutrophil count, × 10⁹/L

1.8 - 6.3

3.4 (2.5 - 4.2)

8%↑

3.1 (2.5 - 3.8)

4%↑

12%↓

6%↓

Neutrophil ratio, %

40.0 - 75.0

67.7 (60.1 - 75.8)

26%↑

62.0 (56.4 - 66.6)

3%↑

Lymphocyte count, × 10⁹/L

1.1 - 3.2

1.0 (0.8 - 1.4)

56%↓

1.4 (1.1 - 1.7)

23%↓

Lymphocyte ratio, %

20.0 - 50.0

22.1 (16.4 - 29.7)

39%↓

26.8 (22.9 - 31.9)

13%↓

Red blood cell count, × 10¹²/L

51%↓

52%↓

Female

3.8 - 5.1

3.8 (3.5 - 4.2)

3.8 (3.4 - 4.0)

Male

4.3 - 5.8

4.2 (3.9 - 4.5)

4.1 (3.8 - 4.6)

Hemoglobin, g/L

49%↓

46%↓

Female

115.0 - 150.0

113 (103 - 127)

112 (101.5 - 120)

Male

130.0 - 175.0

131 (123 - 144)

128.5 (119.0 - 138.3)

Hematocrit, %

56%↓

55%↓

Female

35.0 - 45.0

34.3 (32.2 - 38.3)

34.1 (31.5 - 36.8)

Male

40.0 - 50.0

39.4 (36.1 - 43.2)

38.3 (35.6 - 41.5)

Platelet count, × 10⁹/L

125.0 - 350.0

226.0 (168.5 - 313.0)

15%↑

221 (178.0 - 275.8)

8%↑

7%↓

3%↓

hsCRP, mg/L

0 - 8.0

16.3 (2.9 - 62.7)

60%↑

1.7 (1.1 - 5.8)

21%↑

ESR, mm/h

0 - 20.0

64.0 (34.0 - 94.5)

89%↑

50.0 (24.0 - 80.0)

86%↑

D-dimer, mg/L

0 - 1.0

0.4 (0.3 - 0.8)

20%↑

0.3 (0.2 - 0.5)

7 %↑

Fibrinogen, g/L

2.0 - 4.0

4.1 (2.9 - 4.7)

51%↑

2.9 (2.4 - 3.3)

9%↑

FDP, mg/L

0 - 3.0

2.6 (1.6 - 4.1)

41%↑

1.9 (1.5 - 3.1)

27%↑

NT-proBNP^a, pg/mL

10%↑

2%↑

< 50 years

0 - 450.0

120.0 (65.0 - 244.6)

82.8 (54.3 - 162.8)

50 - 75 years

0 - 900.0

296.5 (110.4 - 552.5)

186.3 (119.5 - 351.8)

> 75 years

0 - 1,800.0

1,287.8 (611.1 - 1,467.7)

365.7 (288.1 - 430.6)

hs-cTnL, ng/mL

0 - 0.1

0.001 (0.001 - 0.004)

0↑

CK, U/L

20.0 - 190.0

64.0 (33.5 - 125.0)

16%↑

45.0 (31.0 - 57.3)

0↑

LDH, U/L

114.0 - 240.0

228.0 (182.0 - 284.5)

46%↑

175.5 (152.5 - 217.8)

15%↑

**Table 3.** Statistically Significant Biomarkers on Admission and at Discharge With Different Ages
	< 45 (n = 29)	45 - 60 (n = 38)	> 60 (n = 40)
Data are expressed with the median (IQR). P values comparing different age groups are from one-way ANOVA. ^aP < 0.05 for 45 - 60 group and < 45 group vs. > 60 group has statistical difference. ^bP < 0.05 for < 45 group vs. > 60 group has statistical difference. In for the data collected on admission, out for data collected at discharge. CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; FDP: fibrinogen degradation product; CK: creatine kinase; IQR: interquartile range.
CRP (in)	7.2 (0.7 - 53.2)	15.1 (2.5 - 44.3)	51.9 (6.5 - 94.4)^a
ESR (in)	35.0 (23.0 - 65.0)	53.0 (32.5 - 90.5)	87.5 (56.0 - 107.3)^a
ESR (out)	23.0 (21.0 - 46.0)	42.0 (25.0 - 63.0)	71.0 (34.5 - 98.3)^a
Fibrinogen (in)	3.6 (2.2 - 4.7)	4.1 (2.8 - 4.6)	4.4 (3.5 - 5.3)^b
FDP (out)	1.7 (1.4 - 2.3)	1.8 (1.4 - 2.2)	2.9 (1.9 - 4.1)^a
D - dimer (out)	0.3 (0.2 - 0.4)	0.3 (0.2 - 0.4)	0.49 (0.32 - 0.82)^a
CK	79.0 (50.0 - 161.0)	78.5 (33.3 - 135.3)	49.0 (30.8 - 79.8)^b

Table 3. Statistically Significant Biomarkers on Admission and at Discharge With Different Ages

< 45 (n = 29)

45 - 60 (n = 38)

> 60 (n = 40)

Data are expressed with the median (IQR). P values comparing different age groups are from one-way ANOVA. ^aP < 0.05 for 45 - 60 group and < 45 group vs. > 60 group has statistical difference. ^bP < 0.05 for < 45 group vs. > 60 group has statistical difference. In for the data collected on admission, out for data collected at discharge. CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; FDP: fibrinogen degradation product; CK: creatine kinase; IQR: interquartile range.

CRP (in)

7.2 (0.7 - 53.2)

15.1 (2.5 - 44.3)

51.9 (6.5 - 94.4)^a

ESR (in)

35.0 (23.0 - 65.0)

53.0 (32.5 - 90.5)

87.5 (56.0 - 107.3)^a

ESR (out)

23.0 (21.0 - 46.0)

42.0 (25.0 - 63.0)

71.0 (34.5 - 98.3)^a

Fibrinogen (in)

3.6 (2.2 - 4.7)

4.1 (2.8 - 4.6)

4.4 (3.5 - 5.3)^b

FDP (out)

1.7 (1.4 - 2.3)

1.8 (1.4 - 2.2)

2.9 (1.9 - 4.1)^a

D - dimer (out)

0.3 (0.2 - 0.4)

0.49 (0.32 - 0.82)^a

79.0 (50.0 - 161.0)

78.5 (33.3 - 135.3)

49.0 (30.8 - 79.8)^b