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

被引:234
作者
Wang, Dawei [1 ]
Yin, Yimei [2 ]
Hu, Chang [1 ]
Liu, Xing [1 ]
Zhang, Xingguo [3 ]
Zhou, Shuliang [1 ]
Jian, Mingzhi [4 ]
Xu, Haibo [5 ]
Prowle, John [6 ]
Hu, Bo [1 ]
Li, Yirong [7 ]
Peng, Zhiyong [1 ]
机构
[1] Wuhan Univ, Dept Crit Care Med, Zhongnan Hosp, Wuhan 430071, Hubei, Peoples R China
[2] Wuhan Univ, Dept Ultrasound Med, Zhongnan Hosp, Wuhan 430071, Hubei, Peoples R China
[3] Xishui Hosp, Dept Crit Care Med, Huanggang, Hubei, Peoples R China
[4] Ctr Dis Control & Prevent, Dept Hlth Educ, Shaoxing 312000, Zhejiang, Peoples R China
[5] Wuhan Univ, Dept Radiol, Zhongnan Hosp, Wuhan 430071, Hubei, Peoples R China
[6] Barts Hlth NHS Trust, Adult Crit Care Unit, Royal London Hosp, London, England
[7] Wuhan Univ, Dept Lab Med, Zhongnan Hosp, Wuhan 430071, Hubei, Peoples R China
关键词
Coronavirus; Infection; Pneumonia;
D O I
10.1186/s13054-020-02895-6
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
BackgroundIn 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.MethodsRetrospective 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.ResultsA 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.ConclusionsA period of 7-13days 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.
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页数:9
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