Clinical Characteristics and Disease Progression in Early-Stage COVID-19 Patients in South Korea

Min Hyuk Choi; Hyunmin Ahn; Han Seok Ryu; Byung-Jun Kim; Joonyong Jang; Moonki Jung; Jinuoung Kim; Seok Hoon Jeong

doi:10.3390/jcm9061959

Clinical Characteristics and Disease Progression in Early-Stage COVID-19 Patients in South Korea

J Clin Med. 2020 Jun 23;9(6):1959. doi: 10.3390/jcm9061959.

Authors

Min Hyuk Choi^{1

2}, Hyunmin Ahn³, Han Seok Ryu⁴, Byung-Jun Kim⁴, Joonyong Jang⁴, Moonki Jung⁴, Jinuoung Kim⁴, Seok Hoon Jeong¹

Affiliations

¹ Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul 06273, Korea.
² Department of Laboratory Medicine, Armed Forces Daegu Hospital, Daegu 712-906, Korea.
³ Department of Ophthalmology, Armed Forces Daegu Hospital, Daegu 712-906, Korea.
⁴ Department of Internal Medicine, Armed Forces Daegu Hospital, Daegu 712-906, Korea.

Abstract

A rapid increase in the number of patients with coronavirus disease 19 (COVID-19) may overwhelm the available medical resources. We aimed to evaluate risk factors for disease severity in the early stages of COVID-19. The cohort comprised 293 patients with COVID-19 from 5 March 2020, to 18 March 2020. The Korea Centers for Disease Control and Prevention (KCDC) classification system was used to triage patients. The clinical course was summarized, including the impact of drugs (angiotensin II receptor blockers [ARB], ibuprofen, and dipeptidyl peptidase-4 inhibitors [DPP4i]) and the therapeutic effect of lopinavir/ritonavir. After adjusting for confounding variables, prior history of drug use, including ARB, ibuprofen, and DPP4i was not a risk factor associated with disease progression. Patients treated with lopinavir/ritonavir had significantly shorter progression-free survival than those not receiving lopinavir/ritonavir. KCDC classification I clearly distinguished the improvement/stabilization group from the progression group of COVID-19 patients (AUC 0.817; 95% CI, 0.740-0.895).

Keywords: Korea centers for disease control and prevention (KCDC) classification; angiotensin II receptor blockers (ARB); coronavirus disease-19 (COVID-19); ibuprofen; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).