Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province

By Kui Liu, Yuan-yuan Fang, Yan Deng, Wei Liu, Meifang Wang, Jing Ma, W. Xiao, Ying-Nan Wang, Minhua Zhong, Cheng-hong Li and 2 more. Chinese Medical Journal, 2020

1,283 citations recorded by the source corpus.

Abstract Background The 2019 novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiologic history, and analyze the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak. Methods Clinical data from 137 2019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30, 2019 to January 24, 2020 were retrospectively collected, including general status, clinical manifestations, laboratory test results, imaging characteristics, and treatment regimens. Results None of the 137 patients (61 males, 76 females, aged 20–83 years, median age 57 years) had a definite history of exposure to Huanan Seafood Wholesale Market. Major initial symptoms included fever (112/137, 81.8%), coughing (66/137, 48.2%), and muscle pain or fatigue (44/137, 32.1%), with other, less typical initial symptoms observed at low frequency, including heart palpitations, diarrhea, and headache. Nearly 80% of the patients had normal or decreased white blood cell counts, and 72.3% (99/137) had lymphocytopenia. Lung involvement was present in all cases, with most chest computed tomography scans showing lesions in multiple lung lobes, some of which were dense; ground-glass opacity co-existed with consolidation shadows or cord-like shadows. Given the lack of effective drugs, treatment focused on symptomatic and respiratory support. Immunoglobulin G was delivered to some critically ill patients according to their conditions. Systemic corticosteroid treatment did not show significant benefits. Notably, early respiratory support facilitated disease recovery and improved prognosis. The risk of death was primarily associated with age, underlying chronic diseases, and median interval from the appearance of initial symptoms to dyspnea. Conclusions The majority of patients with 2019-nCoV pneumonia present with fever as the first symptom, and most of them still showed typical manifestations of viral pneumonia on chest imaging. Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.

Subfields: Infectious Diseases, Obstetrics and Gynecology

View Paper: https://www.semanticscholar.org/paper/2091676545923b07bef6be42d0345f40e8b1d8d0

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Citations in the corpus

Artificial Intelligence and COVID-19: Deep Learning Approaches for Diagnosis and Treatment (2020, background): “From mild, self-limiting respiratory tract illness to severe progressive pneumonia, multiorgan failure, and death [1]–[4].”
Cytokine Storm in COVID-19: The Current Evidence and Treatment Strategies (2020, background): “Newly published studies also indicate that the use of corticosteroids is not beneficial for COVID-19 patients (not severe cases), and high-dose corticosteroids are associated with mortality (44, 66, 67).”
Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis (2020, background): “Despite considerable variations in the proportion in individual studies due to the limited sample size and the region where patients were managed, circulatory diseases (including hypertension and coronary heart diseases) remained the most common category of comorbidity [3-7].”
COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options (2020, background): “Moreover, ACE2 expression is up-regulated in failing human hearts, suggesting a plausible explanation for a higher infectivity of virus and a higher mortality in patients with heart failure.(18)”
Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis (2020, neutral): “Despite the inclusion of >60 reports, the actual prevalence of any gastrointestinal symptoms could be underestimated because many earlier studies did not report other gastrointestinal symptoms except for diarrhea.(19,24,34,35,40,42) Moreover, the majority of studies reported gastrointestinal symptom”
Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. (2020, neutral): “Kui [33] Yes Yes CD CD NA Yes CD Yes Yes Fair Fair”
Cardiovascular complications in COVID-19 (2020, positive): “Palpitations may be a presenting symptom in over 7% of patients with COVID-19 [26] .”
SARS-CoV-2 invades host cells via a novel route: CD147-spike protein (2020, background): “Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis [18] .”
COVID-19 and Multiorgan Response (2020, neutral): “41, 42 The type of arrhythmias are variable and aetiology can be multi-factorial, ranging from hypoxic state due to ARDS to myocarditis.”