Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.
Dawei Wang,Bo Hu,Chang Hu,Fangfang Zhu,Xing Liu,Jing Zhang,Binbin Wang,Hui Xiang,Zhenshun Cheng,Yong Xiong,Yan Zhao,Yirong Li,Xinghuan Wang,Zhiyong Peng +13 more
TLDR
The epidemiological and clinical characteristics of novel coronavirus (2019-nCoV)-infected pneumonia in Wuhan, China, and hospital-associated transmission as the presumed mechanism of infection for affected health professionals and hospitalized patients are described.Abstract:
Importance In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited. Objective To describe the epidemiological and clinical characteristics of NCIP. Design, Setting, and Participants Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020. Exposures Documented NCIP. Main Outcomes and Measures Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Results Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0). Conclusions and Relevance In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.read more
Citations
More filters
Journal ArticleDOI
Risk Factors for Mortality in Patients with COVID-19 in New York City.
Takahisa Mikami,Hirotaka Miyashita,Hirotaka Miyashita,Takayuki Yamada,Takayuki Yamada,Matthew Harrington,Matthew Harrington,Daniel I. Steinberg,Daniel I. Steinberg,Andrew Dunn,Andrew Dunn,Evan Siau,Evan Siau +12 more
TL;DR: Among patients with COVID-19, older age, male sex, hypotension, tachypnea, hypoxia, impaired renal function, elevated D-dimer, and elevated troponin were associated with increased in- hospital mortality and hydroxychloroquine use was associated with decreased in-hospital mortality.
Journal ArticleDOI
Comorbid chronic diseases are strongly correlated with disease severity among COVID-19 patients: A systematic review and meta-analysis
TL;DR: In this paper, the effects of comorbid chronic diseases on clinical outcomes of COVID-19 were explored in PubMed, Ovid MEDLINE, EMBASE, CDC, and NIH databases to April 25, 2020.
Journal ArticleDOI
Prediction model and risk scores of ICU admission and mortality in COVID-19.
Zirun Zhao,Anne Chen,Wei Hou,James M. Graham,Haifang Li,Paul Richman,Henry C. Thode,Adam J. Singer,Timothy Q. Duong +8 more
TL;DR: A risk score system based on clinical characteristics at presentation to predict intensive care unit (ICU) admission and mortality in COVID-19 patients may prove useful for frontline physicians in clinical decision-making under time-sensitive and resource-constrained environment.
Journal ArticleDOI
Coronavirus disease 2019, superinfections, and antimicrobial development: what can we expect?
TL;DR: Based on limited data from case series, it is reasonable to anticipate that an appreciable minority of patients with severe COVID-19 will develop superinfections, most commonly pneumonia due to nosocomial bacteria and Aspergillus.
Journal ArticleDOI
30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study.
Andrea Giacomelli,Anna Lisa Ridolfo,Laura Milazzo,Letizia Oreni,Dario Bernacchia,Matteo Siano,Cecilia Bonazzetti,Alice Covizzi,Marco Schiuma,Matteo Passerini,Marco Piscaglia,Massimo Coen,Guido Gubertini,Giuliano Rizzardini,Chiara Cogliati,Anna Maria Brambilla,Riccardo Colombo,Antonio Castelli,Roberto Rech,Agostino Riva,Alessandro Torre,Luca Meroni,Stefano Rusconi,Spinello Antinori,Massimo Galli +24 more
TL;DR: Evidence is added to the notion that older age, obesity and more advanced illness are factors associated to an increased risk of death among patients hospitalized with COVID-19.
References
More filters
Journal ArticleDOI
Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Chaolin Huang,Yeming Wang,Xingwang Li,Lili Ren,Jianping Zhao,Yi Hu,Li Zhang,Guohui Fan,Jiuyang Xu,Xiaoying Gu,Zhenshun Cheng,Ting Yu,Jia'an Xia,Yuan Wei,Wenjuan Wu,Xuelei Xie,Wen Yin,Li Hui,Min Liu,Yan Xiao,Hong Gao,Li Guo,Jungang Xie,Guang-Fa Wang,Rongmeng Jiang,Zhancheng Gao,Qi Jin,Jianwei Wang,Bin Cao +28 more
TL;DR: The epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of patients with laboratory-confirmed 2019-nCoV infection in Wuhan, China, were reported.
Journal ArticleDOI
A Novel Coronavirus from Patients with Pneumonia in China, 2019.
Na Zhu,Dingyu Zhang,Wenling Wang,Xingwang Li,Bo Yang,Jingdong Song,Xiang Zhao,Baoying Huang,Weifeng Shi,Roujian Lu,Peihua Niu,Faxian Zhan,Xuejun Ma,Dayan Wang,Wenbo Xu,Wenbo Xu,Guizhen Wu,George F. Gao,Wenjie Tan +18 more
TL;DR: Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily, which is the seventh member of the family of coronaviruses that infect humans.
Journal ArticleDOI
Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
Nanshan Chen,Min Zhou,Xuan Dong,Jie-Ming Qu,Fengyun Gong,Yang Han,Yang Qiu,Jingli Wang,Ying Liu,Yuan Wei,Jia'an Xia,Ting Yu,Xinxin Zhang,Li Zhang +13 more
TL;DR: Characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia, and further investigation is needed to explore the applicability of the Mu LBSTA scores in predicting the risk of mortality in 2019-nCoV infection.
Journal ArticleDOI
Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia.
Qun Li,Xuhua Guan,Peng Wu,Xiaoye Wang,Lei Zhou,Yeqing Tong,Ruiqi Ren,Kathy Leung,Eric H. Y. Lau,Jessica Y. Wong,Xuesen Xing,Nijuan Xiang,Yang Wu,Chao Li,Chen Qi,Dan Li,Tian Liu,Jing Zhao,Man Liu,Wenxiao Tu,Chuding Chen,Lianmei Jin,Rui Yang,Qi Wang,Suhua Zhou,Rui Wang,Hui Liu,Yingbo Luo,Yuan Liu,Ge Shao,Huan Li,Zhongfa Tao,Yang Yang,Yang Yang,Zhiqiang Deng,Boxi Liu,Zhitao Ma,Yanping Zhang,Guoqing Shi,Tommy Tsan-Yuk Lam,Joseph T. Wu,George F. Gao,George F. Gao,Benjamin J. Cowling,Bo Yang,Gabriel M. Leung,Zijian Feng +46 more
TL;DR: There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019 and considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere.
Journal ArticleDOI
Acute respiratory distress syndrome: the Berlin Definition.
Ards Definition Task Force,V. Marco Ranieri,Gordon D. Rubenfeld,B. Taylor Thompson,Niall D. Ferguson,Ellen Caldwell,Eddy Fan,Luigi Camporota,Luigi Camporota,Arthur S. Slutsky +9 more
TL;DR: The updated and revised Berlin Definition for ARDS addresses a number of the limitations of the AECC definition and may serve as a model to create more accurate, evidence-based, critical illness syndrome definitions and to better inform clinical care, research, and health services planning.
Related Papers (5)
Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Chaolin Huang,Yeming Wang,Xingwang Li,Lili Ren,Jianping Zhao,Yi Hu,Li Zhang,Guohui Fan,Jiuyang Xu,Xiaoying Gu,Zhenshun Cheng,Ting Yu,Jia'an Xia,Yuan Wei,Wenjuan Wu,Xuelei Xie,Wen Yin,Li Hui,Min Liu,Yan Xiao,Hong Gao,Li Guo,Jungang Xie,Guang-Fa Wang,Rongmeng Jiang,Zhancheng Gao,Qi Jin,Jianwei Wang,Bin Cao +28 more
Clinical Characteristics of Coronavirus Disease 2019 in China.
Wei-jie Guan,Zhengyi Ni,Yu Hu,Wenhua Liang,Chun-Quan Ou,Jianxing He,Lei Liu,Hong Shan,Chunliang Lei,David S.C. Hui,Bin Du,Lanjuan Li,Guang Zeng,Kowk-Yung Yuen,Ruchong Chen,Chun-Li Tang,Tao Wang,Ping-Yan Chen,Jie Xiang,Shiyue Li,Jinlin Wang,Zi-jing Liang,Yi-xiang Peng,Li Wei,Yong Liu,Ya-hua Hu,Peng Peng,Jian-ming Wang,Ji-yang Liu,Zhong Chen,Gang Li,Zhi-jian Zheng,Shao-qin Qiu,Jie Luo,Chang-jiang Ye,Shao-yong Zhu,Nanshan Zhong +36 more