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researchsquare; 2020.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-20112.v2

ABSTRACT

Background: Novel coronavirus disease 2019 (COVID-19) has spread around the world; therefore, more attention should be paid to the clinical features of COVID-19, with the aim of improving the diagnosis and treatment of patients. Methods: By 15 February 2020, 60 patients diagnosed with COVID-19 had been admitted to Nanjing Second Hospital. We analyzed the clinical features of different age segments infected with COVID-19 prospectively, including epidemiological, clinical, laboratory, and radiological characteristics; treatment, clinical outcomes, and prognosis of this cohort of patients. Results: The cohort comprised 29 male and 31 female patients (median age = 46.18 years old (range: 18–97). Fifty-five (91.7%) patients had a clear epidemiological contact history. The average incubation period was 7.92 days. The most common clinical manifestations were fever (85%) and cough (75%). Peripheral white blood cell counts were mostly normal at admission, 7 days, and 14 days, with no differences among patients of different ages. The lymphocyte counts of all patients were in the normal range on admission, and after 7 days and 14 days of treatment; however, the lymphocyte count in > 65-year-old patients was less than that in the < 40 and 40–65-year-old groups after 7 and 14 days of treatment (P < 0.05, respectively). At admission, the CD4 T lymphocyte count was within the normal range; however, the CD4 T lymphocyte count in >65-year-old group was less than that in the < 40 and 40–65-years-old groups after 14 days of treatment. The CD4 T lymphocyte counts were 723.46 ± 243.82/ml (< 40), 640.00 ± 242.30/ml (40–65), and 399.88 ± 256.16/ml (> 65) (P =0.0075). The > 65-years-old group had higher levels of lactate dehydrogenase (269.83 ± 73.36 vs. 208.52 ± 35.67 and 243.83 ± 76.66) after 14 days (P = 0.0496). Imaging revealed more lesions in the 40–65 and > 65-year-old groups (P < 0.0001). The days after the nucleic acid detection turned negative in the three age groups were: 9.19 ± 3.93 (< 40), 10.04 ± 4.10 (40–65), and 13.57 ± 2.76 (> 65) (P = 0.0373). After antiviral treatment, together with anti-infection regimen if the patient with lung infection and continuous oxygen inhalation if the patient is hypoxic, all patients achieved total recovery and were discharged with follow-up. Conclusion: Patients with COVID-19 pneumonia generally had an epidemiological history. Older patients showed more extensive lesions upon admission, more severe illness, slower recovery of immune function, the longer viral nucleic acid persistence. 


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COVID-19
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