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Clinical characteristics of COVID-19 patients in three consecutive generations of spread in Zhejiang, China.
Clin Microbiol Infect. 2020 Oct; 26(10):1380-1385.CM

Abstract

OBJECTIVES

The aim was to determine the clinical characteristics of COVID-19 patients because the SARS-CoV-2 virus continues to circulate in the population.

METHODS

This is a retrospective, multicentre, cohort study. Adult COVID-19 cases from four hospitals in Zhejiang were enrolled and clustered into three groups based on epidemiological history. First-generation patients had a travel history to Hubei within 14 days before disease onset; second-generation patients had a contact history with first-generation patients; third-generation patients had a contact history with second-generation patients. Demographic, clinical characteristics, clinical outcomes and duration of viral shedding were analysed.

RESULTS

A total of 171 patients were enrolled, with 83, 44 and 44 patients in the first-, second-, and third-generation, respectively. Compared with the first and second generations, third-generation patients were older (61.3 vs. 48.3 and 44.0 years, p < 0.001) and had more coexisting conditions (56.8% vs. 36.1% and 27.3%, p 0.013). At 7 ± 1 days from illness onset, third-generation patients had lower lymphocyte (0.6 vs. 0.8 and 0.8 × 109/L, p 0.007), higher C-reactive protein (29.7 vs. 17.1 and 13.8 mg/L, p 0.018) and D-dimer (1066 vs. 412.5 and 549 μg/L, p 0.002) and more lesions involving the pulmonary lobes (lobes ≥5, 81.8% vs. 53.0% and 34.1%, p < 0.001). The proportions of third-generation patients developing severe illness (72.7% vs. 32.5% and 27.3%, p < 0.001), critical illness (38.6% vs. 10.8% and 6.8%, p < 0.001) and receiving endotracheal intubation (20.5% vs. 3.6% and 2.3%, p 0.002) were higher than in the other two groups.

DISCUSSION

Third-generation patients were older, had more underlying comorbidities and had a higher proportion of severe or critical illness than first- and second-generation patients.

Authors+Show Affiliations

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China.Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province, Taizhou, China.Department of Respiratory and Critical Care Medicine, Yuhang First People's Hospital, Hangzhou, China.Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Laboratory Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Anaesthesiology and Pain Research Centre, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China.Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: zjyhz@zju.edu.cn.Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: zhouhua1@zju.edu.cn.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32593742

Citation

Yao, Y, et al. "Clinical Characteristics of COVID-19 Patients in Three Consecutive Generations of Spread in Zhejiang, China." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 26, no. 10, 2020, pp. 1380-1385.
Yao Y, Chen W, Wu X, et al. Clinical characteristics of COVID-19 patients in three consecutive generations of spread in Zhejiang, China. Clin Microbiol Infect. 2020;26(10):1380-1385.
Yao, Y., Chen, W., Wu, X., Shen, L., Shen, L., Fu, Y., Yang, Q., Yao, M., Zhou, J., & Zhou, H. (2020). Clinical characteristics of COVID-19 patients in three consecutive generations of spread in Zhejiang, China. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 26(10), 1380-1385. https://doi.org/10.1016/j.cmi.2020.06.018
Yao Y, et al. Clinical Characteristics of COVID-19 Patients in Three Consecutive Generations of Spread in Zhejiang, China. Clin Microbiol Infect. 2020;26(10):1380-1385. PubMed PMID: 32593742.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics of COVID-19 patients in three consecutive generations of spread in Zhejiang, China. AU - Yao,Y, AU - Chen,W, AU - Wu,X, AU - Shen,L, AU - Shen,L, AU - Fu,Y, AU - Yang,Q, AU - Yao,M, AU - Zhou,J, AU - Zhou,H, Y1 - 2020/06/25/ PY - 2020/04/22/received PY - 2020/06/17/revised PY - 2020/06/18/accepted PY - 2020/7/1/pubmed PY - 2020/9/30/medline PY - 2020/6/29/entrez KW - COVID-19 KW - Clinical characteristics KW - Epidemiology KW - SARS-CoV-2 KW - Severity SP - 1380 EP - 1385 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin Microbiol Infect VL - 26 IS - 10 N2 - OBJECTIVES: The aim was to determine the clinical characteristics of COVID-19 patients because the SARS-CoV-2 virus continues to circulate in the population. METHODS: This is a retrospective, multicentre, cohort study. Adult COVID-19 cases from four hospitals in Zhejiang were enrolled and clustered into three groups based on epidemiological history. First-generation patients had a travel history to Hubei within 14 days before disease onset; second-generation patients had a contact history with first-generation patients; third-generation patients had a contact history with second-generation patients. Demographic, clinical characteristics, clinical outcomes and duration of viral shedding were analysed. RESULTS: A total of 171 patients were enrolled, with 83, 44 and 44 patients in the first-, second-, and third-generation, respectively. Compared with the first and second generations, third-generation patients were older (61.3 vs. 48.3 and 44.0 years, p < 0.001) and had more coexisting conditions (56.8% vs. 36.1% and 27.3%, p 0.013). At 7 ± 1 days from illness onset, third-generation patients had lower lymphocyte (0.6 vs. 0.8 and 0.8 × 109/L, p 0.007), higher C-reactive protein (29.7 vs. 17.1 and 13.8 mg/L, p 0.018) and D-dimer (1066 vs. 412.5 and 549 μg/L, p 0.002) and more lesions involving the pulmonary lobes (lobes ≥5, 81.8% vs. 53.0% and 34.1%, p < 0.001). The proportions of third-generation patients developing severe illness (72.7% vs. 32.5% and 27.3%, p < 0.001), critical illness (38.6% vs. 10.8% and 6.8%, p < 0.001) and receiving endotracheal intubation (20.5% vs. 3.6% and 2.3%, p 0.002) were higher than in the other two groups. DISCUSSION: Third-generation patients were older, had more underlying comorbidities and had a higher proportion of severe or critical illness than first- and second-generation patients. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/32593742/Clinical_characteristics_of_COVID_19_patients_in_three_consecutive_generations_of_spread_in_Zhejiang_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(20)30362-1 DB - PRIME DP - Unbound Medicine ER -