OBJECTIVE: To explore the correlation between early inflammation indicators and 
the severity of coronavirus disease 2019 (COVID-19).
METHODS: A retrospective study was conducted. Patients with COVID-19 admitted to 
Wenzhou Central Hospital from January 17 to February 14, 2020 were enrolled. The 
general information, chest CT before admission, the first laboratory parameters 
and chest CT within 24 hours after admission were collected. Patients were 
followed up for 30 days after the first onset of dyspnea or pulmonary imaging 
showed that the lesions progressed more than 50% within 24 to 48 hours 
(according to the criteria for severe cases) as the study endpoint. According to 
the endpoint, the patients were divided into two groups: mild type/common type 
group and severe/critical group, and the differences in general information and 
inflammation index of the two groups were compared. Logistic regression was used 
to analyze the inflammation index and the severity of COVID-19. Receiver 
operating characteristic (ROC) curve was draw to evaluate the predictive value 
of early inflammation indicators for severe/critical in patients with COVID-19.
RESULTS: A total of 140 patients with COVID-19 were included, 74 males and 66 
females; the average age was (45±14) years old; 6 cases (4.3%) of mild type, 107 
cases (76.4%) of common type, and 22 cases (15.7%) of severe type, 5 cases 
(3.6%) were critical. There were significantly differences in ages (years old: 
43±13 vs. 57±13), the proportion of patients with one chronic disease (17.7% vs. 
55.6%), C-reactive protein [CRP (mg/L): 7.3 (2.3, 21.0) vs. 40.1 (18.8, 62.6)], 
lymphocyte count [LYM (×109/L): 1.3 (1.0, 1.8) vs. 0.8 (0.7, 1.1)], the 
neutrophil/lymphocyte ratio [NLR: 2.1 (1.6, 3.0) vs. 3.1 (2.2, 8.8)] and 
multilobularinltration, hypo-lymphocytosis, bacterial coinfection, smoking 
history, hyper-tension and age [MuLBSTA score: 5.0 (3.0, 5.0) vs. 5.0 (5.0, 
7.0)] between mild/common group and severe/critical group (all P < 0.05). 
Univariate Logistic regression analysis showed that CRP, NLR, MuLBSTA score, 
age, and whether chronic diseases were associated with the severity of COVID-19 
[odds ratio (OR) and 95% confidence interval (95%CI) were 1.037 (1.020-1.055), 
1.374 (1.123-1.680), 1.574 (1.296-1.911), 1.082 (1.042-1.125), 6.393 
(2.551-16.023), respectively, all P < 0.01]. Further multivariate Logistic 
regression analysis showed that CRP and MuLBSTA score were risk factors for the 
development of COVID-19 to severe/critical cases [OR and 95%CI were 1.024 
(1.002-1.048) and 1.321 (1.027-1.699) respectively, both P < 0.05]. ROC curve 
analysis showed that the area under the curve for CRP and MuLBSTA score to 
predict severe/critical cases were both 0.818, and the best cut-off points were 
27.4 mg/L and 6.0 points, respectively.
CONCLUSIONS: CRP and MuLBSTA score are related to the severity of COVID-19, and 
may have good independent predictive ability for the development of 
severe/critical illness.