Journal Article

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

Fang, Yuan-Yuan, Wang, Mei-Fang, Liu, Wei, Ma, Jing-Ping, Wang, Ying-Nan, Deng, Yan, Li, Cheng-Hong, Liu, Kui, Xiao, Wei, Liu, Hui-Guo, Zhong, Min-Hua, Li, Guang-Cai

2020

Overview

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. 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. 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. 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.

• Publisher: The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license,Lippincott Williams & Wilkins Ovid Technologies,Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China%Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China%Department of Respiratory and Critical Care Medicine, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan, Hubei 442000, China%Department of Respiratory and Critical Care Medicine, Jingzhou Central Hospital, Jingzhou, Hubei 434020, China%Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Jingzhou, Jingzhou, Hubei 434000, China%Department of Respiratory and Critical Care Medicine, The People’s Hospital of China Three Gorges University, The First People’s Hospital of Yichang, Yichang, Hubei 443000, China%Department of Respiratory and Critical Care Medicine, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, The Central Hospital of Xiaogan, Xiaogan, Hubei 432100, China%Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Jianghan University, Wuhan, Hubei 430015, China%Department of Respiratory and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonmous Prefecture, Enshi Clinical College of Wuhan University, Enshi Tujia and Miao Autonomous Prefecture, Hubei 445000, China,Wolters Kluwer Health,Wolters Kluwer
• Subject: Adult / Age / Aged / Aged, 80 and over / Betacoronavirus / Blood / China / Comorbidity / Coronavirus Infections - complications / Coronavirus Infections - diagnostic imaging / Coronaviruses / COVID-19 / Disease transmission / Dyspnea / Epidemics / Female / Fever / Fever - etiology / Hospitals / Humans / Immunoglobulins / Immunomodulators / Influenza / Laboratories / Male / Medical diagnosis / Middle Aged / Original / Pandemics / Pathogens / Patients / Pneumonia / Pneumonia, Viral - complications / Pneumonia, Viral - diagnostic imaging / Respiratory diseases / Respiratory failure / SARS-CoV-2 / Seafood / Tertiary Care Centers / Tomography, X-Ray Computed / Viral infections / Young Adult