Tags

Type your tag names separated by a space and hit enter

Clinical progression of patients with COVID-19 in Shanghai, China.
J Infect. 2020 05; 80(5):e1-e6.JI

Abstract

BACKGROUND

Studies on the 2019 novel coronavirus disease (COVID-19) have generally been limited to the description of the epidemiology and initial clinical characteristics. We investigated the temporal progression in patients with COVID-19.

METHODS

In this retrospective, single-center study, we included confirmed cases of COVID-19 from Jan 20 to Feb 6, 2020 in Shanghai. Final date of follow-up was February 25, 2020.

RESULTS

Of the 249 patients enrolled, the median age was 51 years old, and 126 (50.6%) were male. The duration from onset of symptoms to hospitalization was 4(2-7) days in symptomatic patients. Fever was occurred in 235(94.3%) patients. A total of 215 (86.3%) patients had been discharged after 16(12-20) days hospitalization. The estimated median duration of fever in all the patients with fever was 10 days (95 confidential intervals [CIs]: 8-11 days) after onset of symptoms. Patients who were transferred to intensive care units (ICU) had significantly longer duration of fever as compared to those not in ICU (31 days v.s. 9 days after onset of symptoms, respectively, P <0.0001). Radiological aggravation of initial image was observed in 163 (65.7%) patients on day 7 after onset of symptoms. 154(94.5%) of these patients showed radiological improvement on day 14. The median duration to negative reverse-transcriptase PCR tests of upper respiratory tract samples was 11 days (95 CIs: 10-12 days). Viral clearance was more likely to be delayed in patients in ICU than those not in ICU (P <0.0001). In multivariate logistical analysis, age (Odds ratio [OR] = 1.06) and CD4 T cell count (OR = 0.55 per 100 cells/ul increase) were independently associated with ICU admission.

CONCLUSIONS

The majority of COVID-19 cases are mild. The clinical progression pattern suggests that early control of viral replication and application of host-directed therapy in later stage is essential to improve the prognosis of CVOID-19.

Authors+Show Affiliations

Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Infectious Diseases, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China.Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Respiratory Diseases, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Traditional Chinese Medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Pathogen Diagnosis and Biosafety, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Urology, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China.Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Radiology, Shanghai Public Health Clinical Center, Shanghai 201508, China.Department of Urology, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China. Electronic address: zhutongyu@shphc.org.cn.Department of Infectious Diseases, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China. Electronic address: luhongzhou@fudan.edu.cn.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32171869

Citation

Chen, Jun, et al. "Clinical Progression of Patients With COVID-19 in Shanghai, China." The Journal of Infection, vol. 80, no. 5, 2020, pp. e1-e6.
Chen J, Qi T, Liu L, et al. Clinical progression of patients with COVID-19 in Shanghai, China. J Infect. 2020;80(5):e1-e6.
Chen, J., Qi, T., Liu, L., Ling, Y., Qian, Z., Li, T., Li, F., Xu, Q., Zhang, Y., Xu, S., Song, Z., Zeng, Y., Shen, Y., Shi, Y., Zhu, T., & Lu, H. (2020). Clinical progression of patients with COVID-19 in Shanghai, China. The Journal of Infection, 80(5), e1-e6. https://doi.org/10.1016/j.jinf.2020.03.004
Chen J, et al. Clinical Progression of Patients With COVID-19 in Shanghai, China. J Infect. 2020;80(5):e1-e6. PubMed PMID: 32171869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical progression of patients with COVID-19 in Shanghai, China. AU - Chen,Jun, AU - Qi,Tangkai, AU - Liu,Li, AU - Ling,Yun, AU - Qian,Zhiping, AU - Li,Tao, AU - Li,Feng, AU - Xu,Qingnian, AU - Zhang,Yuyi, AU - Xu,Shuibao, AU - Song,Zhigang, AU - Zeng,Yigang, AU - Shen,Yinzhong, AU - Shi,Yuxin, AU - Zhu,Tongyu, AU - Lu,Hongzhou, Y1 - 2020/03/19/ PY - 2020/03/01/received PY - 2020/03/02/accepted PY - 2020/3/17/pubmed PY - 2020/4/24/medline PY - 2020/3/16/entrez KW - COVID-19 KW - Clinical characteristics KW - Clinical progression KW - SARS-CoV-2 KW - Viral clearance SP - e1 EP - e6 JF - The Journal of infection JO - J Infect VL - 80 IS - 5 N2 - BACKGROUND: Studies on the 2019 novel coronavirus disease (COVID-19) have generally been limited to the description of the epidemiology and initial clinical characteristics. We investigated the temporal progression in patients with COVID-19. METHODS: In this retrospective, single-center study, we included confirmed cases of COVID-19 from Jan 20 to Feb 6, 2020 in Shanghai. Final date of follow-up was February 25, 2020. RESULTS: Of the 249 patients enrolled, the median age was 51 years old, and 126 (50.6%) were male. The duration from onset of symptoms to hospitalization was 4(2-7) days in symptomatic patients. Fever was occurred in 235(94.3%) patients. A total of 215 (86.3%) patients had been discharged after 16(12-20) days hospitalization. The estimated median duration of fever in all the patients with fever was 10 days (95 confidential intervals [CIs]: 8-11 days) after onset of symptoms. Patients who were transferred to intensive care units (ICU) had significantly longer duration of fever as compared to those not in ICU (31 days v.s. 9 days after onset of symptoms, respectively, P <0.0001). Radiological aggravation of initial image was observed in 163 (65.7%) patients on day 7 after onset of symptoms. 154(94.5%) of these patients showed radiological improvement on day 14. The median duration to negative reverse-transcriptase PCR tests of upper respiratory tract samples was 11 days (95 CIs: 10-12 days). Viral clearance was more likely to be delayed in patients in ICU than those not in ICU (P <0.0001). In multivariate logistical analysis, age (Odds ratio [OR] = 1.06) and CD4 T cell count (OR = 0.55 per 100 cells/ul increase) were independently associated with ICU admission. CONCLUSIONS: The majority of COVID-19 cases are mild. The clinical progression pattern suggests that early control of viral replication and application of host-directed therapy in later stage is essential to improve the prognosis of CVOID-19. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/32171869/Clinical_progression_of_patients_with_COVID_19_in_Shanghai_China_ DB - PRIME DP - Unbound Medicine ER -