Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.
武汉市 2019 年 99 例新冠肺炎流行病学和临床特征的描述性研究.
- 作者列表："Chen N","Zhou M","Dong X","Qu J","Gong F","Han Y","Qiu Y","Wang J","Liu Y","Wei Y","Xia J","Yu T","Zhang X","Zhang L
BACKGROUND:In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. METHODS:In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. FINDINGS:Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. INTERPRETATION:The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. FUNDING:National Key R&D Program of China.
背景: 2019 年 12 月，中国武汉市出现了一种与 2019新型冠状病毒(2019-nCoV) 相关的肺炎。我们旨在进一步阐明 2019-nCoV肺炎的流行病学和临床特征。 方法: 在这项回顾性、单中心研究中，我们纳入了 2020 年 1 月 1 日至 1 月 20 日在武汉金银滩医院 20 19-ncov的所有确诊病例。病例经实时RT-PCR确诊，并分析流行病学、人口学、临床和放射学特征及实验室数据。结果随访至 2020 年 1 月 25 日。 结果: 99 例 2019-nCoV肺炎患者中，49 例 (49%) 有华南海鲜市场接触史。患者平均年龄 5 5 · 5 岁 (SD 1 3 · 1)，其中男性 67 例，女性 32 例。所有患者通过实时RT-PCR检测到 2019-nCoV。50 例 (51%) 患者有慢性病。患者有发热 (82 例 [83%] 患者) 、咳嗽 (81 例 [82%] 患者) 、气促 (31 例 [31%] 患者) 、肌肉酸痛 (11 [11%] 患者) 、意识模糊 (9 [9%] 患者) 、头痛 (8 [8%] 患者) 、咽喉痛(5 例 [5%] 患者) 、鼻塞 (4 例 [4%] 患者) 、胸痛 (2 例 [2%] 患者) 、腹泻 (2 例 [2%] 患者) 、和恶心呕吐 (1 例 [1%] 患者)。根据影像学检查，74 例 (75%) 患者表现为双侧肺炎，14 例 (14%) 患者表现为多发性斑驳和磨玻璃样混浊，1 例 (1%) 患者出现气胸。17 例 (17%) 患者发生急性呼吸窘迫综合征，其中 11 例 (11%) 患者在短期内加重，死于多器官功能衰竭。 解释: 2019-nCoV感染是聚集性发病，更有可能影响有合并症的老年男性，并可导致严重甚至致命的呼吸系统疾病，如急性呼吸窘迫综合征。总体而言，死亡患者的特征与MuLBSTA评分一致，后者是预测病毒性肺炎死亡率的早期预警模型。需要进一步研究探讨MuLBSTA评分在预测 2019-nCoV感染死亡风险中的适用性。 基金资助: 国家重点研发项目。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.