Table 3.
Factors Associated With Nonseroconversion in Patients With COVID-19
| Variable | Nonseroconverter | Seroconverter | P | Adjusteda OR (95% CI) | P a |
|---|---|---|---|---|---|
| Sex, male | 22 (66.7) | 59 (59.6) | .539 | ||
| Age, y | 71.0 (62.0–77.0) | 60.0 (53.0–74.0) | .023 | - | |
| Active smoking | 14 (45.2) | 58 (64.4) | .089 | ||
| Charlson comorbidity index | 5.0 (3.0–7.0) | 2.0 (1.0–4.0) | <.001 | 1.35 (1.04–1.76) | .027 |
| Clinical status | |||||
| Days from symptom onset to admission | 3.0 (1.0–8.0) | 7.0 (4.5–10.0) | .004 | - | |
| Days from symptom onset to treatment initiation | 3.0 (2.0–10.0) | 10.0 (6.5–14.0) | <.001 | - | |
| SOFA score on admission | 3.0 (1.0–3.2) | 2.0 (2.0–3.0) | .705 | ||
| Median follow-up | 63.0 (40.0–72.0) | 80.0 (71.0–89.0) | <.001 | - | |
| SpO2/FIO2 on admission | 380.8 (343–462) | 350.0 (339–380) | .051 | 1.01 (1.00–1.02) | .036 |
| Bilateral lung infiltrates on x-ray | 9 (27.3) | 54 (56.2) | .006 | 1.20 (0.28–5.23) | .809 |
| Microbiological data | |||||
| SARS-CoV-2 detected only in fecal samples | 8 (24) | 0 | .001 | ||
| Days from onset to first serological sample | 6 (2–17) | 10.0 (8.0–13.0) | .055 | ||
| Cycle threshold (E gen) | 38 (37–38.7) | 28.0 (25.5–30.5) | <.001 | 1.87 (1.09–3.21) | .023 |
| Time to viral clearance | 3 (1–12) | 41.0 (32.0–76.0) | <.001 | ||
| Biomarkers | |||||
| Interleukin-6, pg/mL | 20.7 (10–41.8) | 25.6 (12.9–88.6) | .189 | ||
| Ferritin, ng/mL | 132.0 (68.1–369) | 377.5 (235–584) | <.002 | 0.99 (0.99–1) | .173 |
| C-reactive protein, mg/L | 35.3 (6.1–66.2) | 50.3 (24.4–99.1) | .023 | 1.10 (0.73–1.66) | .002 |
| LDH | 188.2 (159–228) | 249.5 (211–301) | <.001 | 1.00 (0.99–1) | .769 |
| Fibrinogen, mg/dL | 420.8 (263–554) | 613.0 (440–782) | .001 | 0.99 (0.99–1) | .032 |
| Lymphocytes, ×103/μL | 1.4 (1.1–2.1) | 1.2 (0.9–1.4) | .032 | 0.99 (0.88–1.12) | .951 |
| Neutrophil | 5.9 (4.9–8.6) | 4.2 (3.3–6.2) | .001 | 1.38 (0.96–1.97) | .081 |
| Neutrophil/lymphocytes | 4.2 (3.3–6.2) | 4.7 (3.5–6.6) | .001 | ||
| D-dimer, μg/mL | 1.0 (0.4–2.1) | 0.6 (0.4–1.2) | .121 | ||
| NT-proBNP, pg/mL | 42.0 (7.4–161) | 75 (41.2–200) | .068 | ||
| Outcomes | |||||
| Death | 2 (6.1) | 2 (2.0) | .260 | ||
| ICU admission | 1 (3) | 13 (13.1) | .188 | ||
| Hospital stay, d | 10 (6.5–14) | 13.0 (10.0–19.0) | .010 | ||
| Anti-COVID-19 therapy | |||||
| HCQ-based combinations | 33 (100.0) | 97 (98.0) | 1.00 | ||
| Azithromycin | 31 (93.9) | 92 (92.9) | 1.00 | ||
| Lopinavir/ritonavir | 22 (66.7) | 98 (99.0) | <.001 | ||
| Remdesivir | 1 (1) | 1.00 | |||
| Interferon-β-1b | 28 (28.3) | <.001 | |||
| Tocilizumab | 5 (15.2) | 70 (70.7) | <.001 | ||
| Methylprednisoloneb | 2 (6.1) | 23 (23.2) | .038 |
aAdjustment was performed by logistic regression. Categorical variables are expressed as No. (%), and continuous variables as median (Q1–Q3).
b1 to 3 bolus of 125-250 mg of methylprednisolone.
Abbreviations: AMI, acute myocardial infarction; COVID-19, coronavirus disease 2019; ICU, intensive care unit; LDH, lactic dehydrogenase; NT-proBNP, N-terminal pro-brain natriuretic peptide; OR, odds ratio; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SOFA, Sequential Organ Failure Assessment; SpO2/FIO2, peripheral blood oxygen saturation/fraction of inspired oxygen rate.