The correlation between viral clearance and biochemical outcomes of 94 COVID-19 infected discharged patients

Abstract

Objective: This study aims to evaluate the correlation between viral clearance and blood biochemical index of 94 discharged patients with COVID-19 infection in Shenzhen Third People's Hospital, enrolled from Jan 5 to Feb 13, 2020.

Methods: The clinical and laboratory findings were extracted from the electronic medical records of the patients. The data were analysed and reviewed by a trained team of physicians. Information on clinical signs and symptoms, medical treatment, virus clearance, and laboratory parameters including interleukin 6 (IL-6) and C-reactive protein were collected.

Results: COVID-19 mRNA clearance ratio was identified significantly correlated with the decline of serum creatine kinase (CK) and lactate dehydrogenase (LDH) levels. Furthermore, COVID-19 mRNA clearance time was positively correlated with the length of hospital stay in patients treated with either IFN-α + lopinavir/ritonavir or IFN-α + lopinavir/ritonavir + ribavirin.

Conclusions: Therapeutic regimens of IFN-α + lopinavir/ritonavir and IFN-α + lopinavir/ritonavir + ribavirin might be beneficial for treatment of COVID-19. Serum LDH or CK decline may predict a favorable response to treatment of COVID-19 infection.

Keywords: CK; COVID-19; Clearance ratio; LDH.

Fig. 1

Changes in the levels of the immune cell types and platelets. Timeline charts illustrate the accounts of immune cell numbers in different admission day. Error bars are SEM. The solid lines in green, yellow and purple represent the mild, moderate and severe group of patients respectively. And the dotted line in black shows the average levels of all patients in each day. One asterisk stands for p < 0.05 for severe group vs moderate group; two stand for p < 0.01, while three stand for p < 0.001 (Color figure online)

Fig. 2

Dynamic Profile of blood biochemical factors. Timeline charts illustrate the blood biochemical factors in different admission day. Error bars are SEM. The solid lines in green, yellow and purple represent the mild, moderate and severe group of patients respectively. And the dotted line in black shows the average levels of all patients in each day. One asterisk stands for p < 0.05 for severe group vs moderate group; two stand for p < 0.01, while three stand for p < 0.001 (Color figure online)

Fig. 3

Regression analysis for serum LDH and CK levels with PCR negative conversion rate. Regression analysis for serum LDH or CK level and virus mRNA elimination rate. a, b The correlation of PCR negative conversion rate and average CK level (r² = 0.822, p = 0.0337) and LDH level (r² = 0.696, p = 0.079) in total patients in each day, respectively. c, d Both significantly inversed correlation between the negative conversion rate and average CK level (r² = 0.843, p = 0.0279) and LDH level (r² = 0.890, p = 0.0161) of PCR positive patients in each day respectively

Fig. 4

Correlation between length of hospital stay and PCR negative conversion time in different antivirus treatment groups. a, b The average lengths of hospital stay and PCR negative conversion times in IFN + lopinavir/ritonavir combined with ribavirin treatment group and IFN + lopinavir/ritonavir treatment group. Error bars are SEM. c, d The correlation of PCR negative conversion time and length of hospital stay (days) in IFN + lopinavir/ritonavir combined with ribavirin treatment group (p = 0.0215) and IFN + lopinavir/ritonavir treatment group (p = 0.012)