Abstract
A pandemic caused by SARS-CoV-2 has infected more than 2 million people
and killed exceeding 150,000 people around the world as of April
19,2020. We obtained the clinical data of all diagnosed patients in
Fuyang, Anhui province to investigate indicators that can be used to
assess severity of COVID-19. Of the 155 patients, 87(56.13%) were
males. The mean age was 41.95 (SD 15.34) years. Only 30(19.35%)
patients had critical condition. Fever (84.52%) followed by cough
(81.94%) were the most common symptoms, and short of breath was more
common in severe patients (P<0.01). Lymphopenia was observed
in most patients (74, 47.7%). It showed the elevation of C-reaction
protein (CRP) in 100 (64.5%) patients and the elevation of serum
amyloid protein A (SAA) in 104 (67.1%) patients. Interleukin 6 (IL-6)
was above the normal range in 104 (67.1%) patients. The calculated
cut-off value of CRP was 19.35 mg/mL, the AUC was 0.777, sensitivity was
73.3%, specificity was 69.6%; SAA was 73.55 mg/L, 0.679, 83.3%,
56.8% respectively; IL-6 was 18.85 pg/mL, 0.797, 83.3%, 64.8%;
D-Dimer was 0.325 mg/L, 0.673, 66.7% and 68.8%. The combination of
CRP, SAA, IL-6 and D-Dimer was 0.823 in AUC, 73.3% in sensitivity and
78.4% in specificity. Old age, co-existing disease and lymphopenia are
related to severe COVID-19. Elevated CRP, SAA, IL-6 and D-Dimer can be
predictors to severe COVID-19. The combination of these four indicators
can improve the effectivity and specificity of assessing severe
COVID-19.