Shorter incubation period is associated with severe disease progression in patients with COVID-19

Changxiang Lai, Rentao Yu, Mingbo Wang, Wenjie Xian, Xin Zhao, Qiyuan Tang, Ruikun Chen, Xuan Zhou, Xuan Li, Zhiyu Li, Zhiwei Li, Guohong Deng, Fang Wang, Changxiang Lai, Rentao Yu, Mingbo Wang, Wenjie Xian, Xin Zhao, Qiyuan Tang, Ruikun Chen, Xuan Zhou, Xuan Li, Zhiyu Li, Zhiwei Li, Guohong Deng, Fang Wang

Abstract

The diagnosed COVID-19 cases revealed that the incubation periods (IP) varied a lot among patients. However, few studies had emphasized on the different clinical features and prognosis of patients with different IP. A total of 330 patients with laboratory-confirmed COVID-19 were enrolled and classified into immediate onset group(IP<3 days, I group, 57 cases) and late onset group(IP>10 days, L group, 75 cases) based on IP. The difference of clinical characteristics and prognosis of the two groups were compared. There were more patients with fever in I group than in L group(P = 0.003), and counts of all the total lymphocytes, total T lymphocytes, CD4 + and CD8 + T lymphocytes were significantly different between the two groups(all P < 0.01). Besides, patients in L group had more GGOs in CT scan than I group and there were more patients in I group receiving antibiotic treatment than in L group(P < 0.001). For disease aggravation, the median CT scores were comparable between the two groups, but individually, there were more patients with increased CT score during hospitalization in I group than in L group. The aggravation incidence of CT presentation was 21.1% in I group, significantly higher than L group(8.0%, P = 0.042). Multivariable COX models suggested that IP was the only independent factors for CT aggravation. Conclusively, patients with different IP were different in clinical symptoms, laboratory tests, and CT presentations. Shorter IP was associated with the aggravation of lung involvement in CT scan.

Keywords: COVID-19; CT scores; SARS-CoV-2; disease aggravation; incubation period.

Conflict of interest statement

All authors declared that they have no conflict of interest to disclosure.

Figures

Figure 1.
Figure 1.
Change trend of CT scores. (a) the overall change of the two group (median with 95% confidence interval). (b) the individual change in I group (c). the individual change in L group. This figure represented different CT severity score of each CT scan during hospitalization. In (b) and (c), each line and dot represented a single patient’s CT score in consecutive times. As the figure showed, there were more patients in I group with an elevated severity scores than in I group during first two examinations, which means more patients exacerbated in CT scan in the beginning
Figure 2.
Figure 2.
Incidence rate of aggravation for the two groups. (a) aggravation of symptoms (b) aggravation of CT presentation. There was no difference in symptom aggravation between the two groups (P = 0.553), but CT severity score elevated significantly in I group than in L group (P = 0.042)

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Source: PubMed

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