ABSTRACT
Objective: To analysis the clinical characteristics of"recurrence"RNA positive patients with Coronavirus disease 2019 ï¼COVID-19ï¼ and compared with those without"recurrence". Methods: 98 patients with COVID-19 in Wuhan Jinyintan Hospital and designated treatment hospitals in Quanzhou were included in this study from February 2020 to April 2020. There were 55 males and 43 femalesï¼ aged from15 to 83 yearsï¼ with a median age of 57.5 yearsï¼ in which 20 cases were complicated with basic diseases. 15 of these patients had been diagnosed and hospitalized had been found as"recurrence"2019-nCoV RNA positive after discharge while the other 83 cases were all negative. The clinical classification of all patients was common type. Clinical data of the COVID-19 RNA"recurrence"patients were collectedï¼ and general situationsï¼ symptomsï¼ laboratory examinations and CT images were also observed and analyzed. The patients were divided into 2019-nCoV"recurrent"group and 2019-nCoV"non-recurrent"group. There are 10 males and 5 females in 2019-nCoV"recurrent"group while 45 males and 38 females in"non-recurrent"group ï¼χ²=0.800ï¼P=0.371ï¼. The age of 2019-nCoV"recurrent"group ï¼57±21ï¼ was higher than that of"non-recurrent"groupï¼53±17ï¼. 8 of 15 the COVID-19"recurrent"group patients and 12 of 83"non-recurrent"patients have basic diseases. IgG and IgM of 2019-nCoVï¼ IL-6ï¼ procalcitoninï¼ ESRï¼ CRPï¼ BNP and other serum biochemical index levels were measured and compared between groups. Results: ï¼1ï¼ The proportion of patients with common type of COVID-19 was 15.3% during 2-week medical observation after discharge. ï¼2ï¼ All of the 2019-nCoV"recurrent"patients were hospitalized due to COVID-19 RNA positiveï¼ when they were quarantined after discharged from hospital. All the patients with mild symptoms which were clarified as common typeï¼ including 5 cases of feverï¼ 6 cases of coughï¼ 5 cases of expectorationï¼ and 2 cases of slight shortness of breath. The time of symptoms appeared on ï¼5.73±2.82ï¼ days after discharge. ï¼3ï¼ The serum procalcitonin of all 2019-nCoV"recurrent"group patients were normalï¼all<0.05 ng/mlï¼. The BNP of"recurrent"group ï¼151±171ï¼ ng/Lï¼ was higher than that of"non-recurrent"group ï¼63±78ï¼ ng/L ï¼t = 3.207ï¼ P = 0.000ï¼. There was no significant difference in laboratory tests like leukocyte ï¼»ï¼6.17±2.4ï¼ and ï¼6.04±2.41ï¼×109/Lï¼½ï¼ lymphocyteï¼»ï¼1.59±0.52ï¼ and ï¼1.32±0.64ï¼×109/Lï¼½ï¼ CRP ï¼»ï¼12.54±28.20ï¼ and ï¼21.74±25.63ï¼mg/Lï¼½ï¼ ESR ï¼»ï¼31.07±28.72ï¼ and ï¼34.10±22.16ï¼mm/1 hï¼½ï¼ AST ï¼»ï¼24.73±9.15ï¼ and ï¼30.24±23.20ï¼U/Lï¼½ï¼ ALT ï¼»ï¼22.60±12.82ï¼ and ï¼36.47±34.12ï¼U/Lï¼ï¼ LDH ï¼»ï¼268±208ï¼ and ï¼270±164ï¼U/Lï¼½ï¼ D-dimer ï¼»ï¼0.60±0.50ï¼ and ï¼0.84±0.98ï¼µg/Lï¼½ï¼ ferritin ï¼»ï¼294±195ï¼ and ï¼395±319ï¼µg/Lï¼½ï¼ IL-6 ï¼»ï¼9.17±6.42ï¼ and ï¼14.28±17.74ï¼ng/Lï¼½ and BUN ï¼5.77±2.66ï¼ and ï¼4.74±2.81ï¼U/Lï¼½ between"recurrent"and"non-recurrent"groups ï¼all P>0.05ï¼. ï¼4ï¼ In"recurrent"groupï¼ ground glassï¼ exudative or solid lesions could be found in most of the chest CT performed on re-admission. Meanwhileï¼ fibrosis lesion was relatively rare. ï¼5ï¼ There were no secondary transmissions were found to be caused by the 2019-nCoV"recurrent"group patients. Conclusions: Most of the 2019-nCoV patients had underlying diseases and active lesions were still found in CT imagesï¼ so the possibility of virus replication may still exist. All"recurrent"patients had mild illness which may suggest that they were in recovery stage, and no evidence of transmission is found.