Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury

Sci China Life Sci. 2020 Mar;63(3):364-374. doi: 10.1007/s11427-020-1643-8. Epub 2020 Feb 9.

Abstract

The outbreak of the 2019-nCoV infection began in December 2019 in Wuhan, Hubei province, and rapidly spread to many provinces in China as well as other countries. Here we report the epidemiological, clinical, laboratory, and radiological characteristics, as well as potential biomarkers for predicting disease severity in 2019-nCoV-infected patients in Shenzhen, China. All 12 cases of the 2019-nCoV-infected patients developed pneumonia and half of them developed acute respiratory distress syndrome (ARDS). The most common laboratory abnormalities were hypoalbuminemia, lymphopenia, decreased percentage of lymphocytes (LYM) and neutrophils (NEU), elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH), and decreased CD8 count. The viral load of 2019-nCoV detected from patient respiratory tracts was positively linked to lung disease severity. ALB, LYM, LYM (%), LDH, NEU (%), and CRP were highly correlated to the acute lung injury. Age, viral load, lung injury score, and blood biochemistry indexes, albumin (ALB), CRP, LDH, LYM (%), LYM, and NEU (%), may be predictors of disease severity. Moreover, the Angiotensin II level in the plasma sample from 2019-nCoV infected patients was markedly elevated and linearly associated to viral load and lung injury. Our results suggest a number of potential diagnosis biomarkers and angiotensin receptor blocker (ARB) drugs for potential repurposing treatment of 2019-nCoV infection.

Keywords: 2019-nCoV; ARDS; Angiotensin II.

MeSH terms

  • Adult
  • Aged
  • Angiotensin II / blood*
  • Betacoronavirus / pathogenicity*
  • Biomarkers / blood*
  • Blood Chemical Analysis
  • Child
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / pathology
  • Humans
  • Lung Injury*
  • Male
  • Middle Aged
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / etiology*
  • Pneumonia, Viral / pathology
  • Respiratory Distress Syndrome, Adult / etiology*
  • Severity of Illness Index
  • Viral Load*

Substances

  • Biomarkers
  • Angiotensin II

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2