Clinical characteristics of 30 cases with corona virus disease 2019 / 中华传染病杂志

ABSTRACT

Objective:To analyze the epidemiological and clinical characteristics of patients with corona virus disease 2019 (COVID-2019) in Shenyang City.Methods:The epidemiological and clinical characteristics of 30 patients diagnosed with COVID-2019 admitted to Shenyang Sixth People′s Hospital from January 22 to February 8, 2020 were retrospectively analyzed. The independent t test, Mann-Whitney test and Fisher′s exact test were used for statistical analysis. Results:Among the 30 cases, 21 were imported, including 17 from Hubei Province and four from other provinces. Nine cases were local infections. There were 18 men and 12 women, aging from 21 to 72 years with the median of 43 years. Eight cases had underlying diseases including hypertension, diabetes, coronary heart disease and bronchitis. On admission, two (7%) cases were mild, 19(63%) cases were ordinary, eight (27%) cases were severe, and one (3%) case was critical. Clinical manifestations mainly included fever, with or without upper respiratory tract symptoms, normal, decreased or slightly increased white blood cell counts, mainly decreased lymphocyte counts, normal or increased C reactive protein, and normal procalcitonin. The computed tomography (CT) of the early stage of the lungs showed that multiple patchy ground glass shadows were mainly accompanied by consolidation, which often involved both lungs or multiple lobes of one lung. At the moment, the clinical treatment mainly included respiratory support, symptomatic treatment, antiviral treatment and anti-bacterial treatment. By February 15, a total of nine cases were cured and discharged, including one mild case, six ordinary cases, and two severe cases. In the comparisons between mild/ordinary patients and severe/critical patients, the fever duration in the severe/critical group (median 11.5 d) was significantly longer than that in the mild/ordinary group (median 2.0 d) ( Z=-2.292, P=0.022), and the laboratory tests indicated more cases with elevated D-dimer levels ( Z=-2.669, P=0.008) and neutrophilic/lymphocyte ratio >3.0 ( Z=-4.071, P<0.01). Conclusions:In Shenyang City, the early cases with COVID-19 infection are mainly imported cases, and expanding local infections gradually develop. Clinical manifestations are mainly characterized by fever and cough. Lung CT imagings show multiple ground glass shadows, mainly accompanied by consolidation. CT changes in the lungs should be closely monitored during the treatment, and CT findings in the lungs may change earlier than the clinical manifestations. Prolonged fever duration, elevated D-dimer level and neutrophil/lymphocyte ratio >3.0 could be used as early warning indicators for severe cases.