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Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China.
Crit Care. 2020 04 30; 24(1):188.CC

Abstract

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.

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Authors+Show Affiliations

Wang D
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Yin Y
Department of Ultrasound Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Hu C
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Liu X
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Zhang X
Department of Critical Care Medicine, Xishui Hospital, Huanggang, Hubei, China.
Zhou S
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Jian M
Department of Health Education, Center for Disease Control and Prevention, Shaoxing, 312000, Zhejiang, China.
Xu H
Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Prowle J
Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, UK.
Hu B
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Li Y
Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China. liyirong838@163.com.
Peng Z
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China. Pengzy5@hotmail.com.

MeSH

Acute Kidney InjuryAdultAge FactorsAgedAged, 80 and overBetacoronavirusCOVID-19ChinaCoronavirus InfectionsCoughFemaleFeverHeartHumansLymphopeniaMaleMiddle AgedPandemicsPatient DischargePneumonia, ViralPrognosisRespiratory Distress SyndromeRetrospective StudiesRisk FactorsSARS-CoV-2Sex FactorsThrombocytopeniaYoung Adult

Pub Type(s)

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

Language

eng

PubMed ID

32354360

Citation

Wang, Dawei, et al. "Clinical Course and Outcome of 107 Patients Infected With the Novel Coronavirus, SARS-CoV-2, Discharged From Two Hospitals in Wuhan, China." Critical Care (London, England), vol. 24, no. 1, 2020, p. 188.
Wang D, Yin Y, Hu C, et al. Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Crit Care. 2020;24(1):188.
Wang, D., Yin, Y., Hu, C., Liu, X., Zhang, X., Zhou, S., Jian, M., Xu, H., Prowle, J., Hu, B., Li, Y., & Peng, Z. (2020). Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Critical Care (London, England), 24(1), 188. https://doi.org/10.1186/s13054-020-02895-6
Wang D, et al. Clinical Course and Outcome of 107 Patients Infected With the Novel Coronavirus, SARS-CoV-2, Discharged From Two Hospitals in Wuhan, China. Crit Care. 2020 04 30;24(1):188. PubMed PMID: 32354360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. AU - Wang,Dawei, AU - Yin,Yimei, AU - Hu,Chang, AU - Liu,Xing, AU - Zhang,Xingguo, AU - Zhou,Shuliang, AU - Jian,Mingzhi, AU - Xu,Haibo, AU - Prowle,John, AU - Hu,Bo, AU - Li,Yirong, AU - Peng,Zhiyong, Y1 - 2020/04/30/ PY - 2020/03/02/received PY - 2020/04/14/accepted PY - 2020/5/2/entrez PY - 2020/5/2/pubmed PY - 2020/5/6/medline KW - Coronavirus KW - Infection KW - Pneumonia SP - 188 EP - 188 JF - Critical care (London, England) JO - Crit Care VL - 24 IS - 1 N2 - 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. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/32354360/Clinical_course_and_outcome_of_107_patients_infected_with_the_novel_coronavirus_SARS_CoV_2_discharged_from_two_hospitals_in_Wuhan_China_ DB - PRIME DP - Unbound Medicine ER -