Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China

Background In December 2019, coronavirus disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series...

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Veröffentlicht in:Critical care (London, England) Jg. 24; H. 1; S. 188 - 9
Hauptverfasser: Wang, Dawei, Yin, Yimei, Hu, Chang, Liu, Xing, Zhang, Xingguo, Zhou, Shuliang, Jian, Mingzhi, Xu, Haibo, Prowle, John, Hu, Bo, Li, Yirong, Peng, Zhiyong
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 30.04.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Acute Kidney Injury - virology
Adult
Adult respiratory distress syndrome
Age Factors
Aged
Aged, 80 and over
Betacoronavirus
Body temperature
China
Comparative analysis
Coronavirus
Coronavirus Infections - diagnosis
Coronavirus Infections - mortality
Coronavirus Infections - therapy
Coronaviruses
Cough - virology
COVID-19
Critical care
Critical Care Medicine
Data collection
Disease transmission
Dyspnea
Emergency Medicine
Epidemiology
Female
Fever
Fever - virology
Genomes
Heart - virology
Hospitals
Humans
Hypertension
Illnesses
Infection
Intensive
Laboratories
Lymphopenia - virology
Male
Medical prognosis
Medical records
Medicine
Medicine & Public Health
Middle Aged
Neutrophils
Pandemics
Patient Discharge
Patient outcomes
Pneumonia
Pneumonia, Viral - diagnosis
Pneumonia, Viral - mortality
Pneumonia, Viral - therapy
Prognosis
Respiratory Distress Syndrome - virology
Retrospective Studies
Risk Factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Sex Factors
Thrombocytopenia - virology
Young Adult
China
United Kingdom
Infection
Pneumonia
Coronavirus
ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
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Zusammenfassung:Background In December 2019, coronavirus disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan and Xishui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic, and clinical data were collected. The clinical course of survivors and non-survivors were compared. Risk factors for death were analyzed. Results A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever, cough, dyspnea, lymphopenia, and radiological multi-lobar pulmonary infiltrates. In severe cases, thrombocytopenia, acute kidney injury, acute myocardial injury, and adult respiratory distress syndrome were observed. During week 2, in mild cases, fever, cough, and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia persisted. In severe cases, leukocytosis, neutrophilia, and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia. However, severe cases showed persistent lymphopenia, severe acute respiratory dyspnea syndrome, refractory shock, anuric acute kidney injury, coagulopathy, thrombocytopenia, and death. Older age and male sex were independent risk factors for poor outcome of the illness. Conclusions A period of 7–13 days after illness onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors for death of COVID-19.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1364-8535
1466-609X
1364-8535
1466-609X
1366-609X
DOI:10.1186/s13054-020-02895-6