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Clinical progression of patients with COVID-19 in Shanghai, China.
Chen, Jun; Qi, Tangkai; Liu, Li; Ling, Yun; Qian, Zhiping; Li, Tao; Li, Feng; Xu, Qingnian; Zhang, Yuyi; Xu, Shuibao; Song, Zhigang; Zeng, Yigang; Shen, Yinzhong; Shi, Yuxin; Zhu, Tongyu; Lu, Hongzhou.
  • Chen J; Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Qi T; Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Liu L; Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Ling Y; Department of Infectious Diseases, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China.
  • Qian Z; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Li T; Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Li F; Department of Respiratory Diseases, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Xu Q; Department of Traditional Chinese Medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Zhang Y; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Xu S; Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Song Z; Department of Pathogen Diagnosis and Biosafety, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Zeng Y; Department of Urology, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China.
  • Shen Y; Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Shi Y; Department of Radiology, Shanghai Public Health Clinical Center, Shanghai 201508, China.
  • Zhu T; Department of Urology, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China. Electronic address: zhutongyu@shphc.org.cn.
  • Lu H; Department of Infectious Diseases, Shanghai Public Health Clinical Center, 2901 Caolang Road, Shanghai 201508, China. Electronic address: luhongzhou@fudan.edu.cn.
J Infect ; 80(5): e1-e6, 2020 05.
Article in English | MEDLINE | ID: covidwho-7451
ABSTRACT

BACKGROUND:

Studies on the 2019 novel coronavirus disease (COVID-19) have generally been limited to the description of the epidemiology and initial clinical characteristics. We investigated the temporal progression in patients with COVID-19.

METHODS:

In this retrospective, single-center study, we included confirmed cases of COVID-19 from Jan 20 to Feb 6, 2020 in Shanghai. Final date of follow-up was February 25, 2020.

RESULTS:

Of the 249 patients enrolled, the median age was 51 years old, and 126 (50.6%) were male. The duration from onset of symptoms to hospitalization was 4(2-7) days in symptomatic patients. Fever was occurred in 235(94.3%) patients. A total of 215 (86.3%) patients had been discharged after 16(12-20) days hospitalization. The estimated median duration of fever in all the patients with fever was 10 days (95 confidential intervals [CIs] 8-11 days) after onset of symptoms. Patients who were transferred to intensive care units (ICU) had significantly longer duration of fever as compared to those not in ICU (31 days v.s. 9 days after onset of symptoms, respectively, P <0.0001). Radiological aggravation of initial image was observed in 163 (65.7%) patients on day 7 after onset of symptoms. 154(94.5%) of these patients showed radiological improvement on day 14. The median duration to negative reverse-transcriptase PCR tests of upper respiratory tract samples was 11 days (95 CIs 10-12 days). Viral clearance was more likely to be delayed in patients in ICU than those not in ICU (P <0.0001). In multivariate logistical analysis, age (Odds ratio [OR] = 1.06) and CD4 T cell count (OR = 0.55 per 100 cells/ul increase) were independently associated with ICU admission.

CONCLUSIONS:

The majority of COVID-19 cases are mild. The clinical progression pattern suggests that early control of viral replication and application of host-directed therapy in later stage is essential to improve the prognosis of CVOID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Disease Progression Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: J Infect Year: 2020 Document Type: Article Affiliation country: J.jinf.2020.03.004

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Disease Progression Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: J Infect Year: 2020 Document Type: Article Affiliation country: J.jinf.2020.03.004