Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study.
中国湖北省非武汉地区 2019 例冠状病毒病患者的临床特征: 一项回顾性研究。
- 作者列表："Zhao XY","Xu XX","Yin HS","Hu QM","Xiong T","Tang YY","Yang AY","Yu BP","Huang ZP
BACKGROUND:Since December 2019, the 2019 coronavirus disease (COVID-19) has expanded to cause a worldwide outbreak that more than 600,000 people infected and tens of thousands died. To date, the clinical characteristics of COVID-19 patients in the non-Wuhan areas of Hubei Province in China have not been described. METHODS:We retrospectively analyzed the clinical characteristics and treatment progress of 91 patients diagnosed with COVID-19 in Jingzhou Central Hospital. RESULTS:Of the 91 patients diagnosed with COVID-19, 30 cases (33.0%) were severe and two patients (2.2%) died. The severe disease group tended to be older (50.5 vs. 42.0 years; p = 0.049) and have more chronic disease (40% vs. 14.8%; p = 0.009) relative to mild disease group. Only 73.6% of the patients were quantitative polymerase chain reaction (qPCR)-positive on their first tests, while typical chest computed tomography images were obtained for each patient. The most common complaints were cough (n = 75; 82.4%), fever (n = 59; 64.8%), fatigue (n = 35; 38.5%), and diarrhea (n = 14; 15.4%). Non-respiratory injury was identified by elevated levels of aspartate aminotransferase (n = 18; 19.8%), creatinine (n = 5; 5.5%), and creatine kinase (n = 14; 15.4%) in laboratory tests. Twenty-eight cases (30.8%) suffered non-respiratory injury, including 50% of the critically ill patients and 21.3% of the mild patients. CONCLUSIONS:Overall, the mortality rate of patients in Jingzhou was lower than that of Wuhan. Importantly, we found liver, kidney, digestive tract, and heart injuries in COVID-19 cases besides respiratory problems. Combining chest computed tomography images with the qPCR analysis of throat swab samples can improve the accuracy of COVID-19 diagnosis.
背景: 自 2019 年 12 月以来，2019 冠状病毒病 (600,000 coronavirus disease，新型冠状病毒肺炎) 已在全球范围内爆发，超过人感染，数万人死亡。迄今为止，中国湖北省非武汉地区新型冠状病毒肺炎患者的临床特征尚未得到描述。 方法: 回顾性分析荆州市中心医院 91 例确诊为新型冠状病毒肺炎患者的临床特点及治疗进展。 结果: 91 例新型冠状病毒肺炎患者中，重症 30 例 (33.0%)，死亡 2 例 (2.2%)。重症组倾向于年龄较大 (50.5 vs. 42.0 年; P = 0.049) 且有较多慢性疾病 (40% vs. 14.8%; P = 0.009) 相对于轻症组。只有 73.6% 的患者首次检测定量聚合酶链反应 (qPCR) 阳性，而每个患者都获得了典型的胸部计算机断层扫描图像。最常见的主诉是咳嗽 (n = 75; 82.4%) 、发热 (n = 59; 64.8% 乏力n = 35; 38.5%) 、和腹泻 (n = 14; 15.4%)。非呼吸损伤通过天冬氨酸氨基转移酶 (n = 19.8%) 、肌酐 (n = 5; 5.5%) 和肌酸激酶 (n = 14) 水平升高来确定; 15.4%) 在实验室测试中。非呼吸系统损伤 28 例 (30.8%)，其中危重病 50%，轻症 21.3%。 结论: 荆州市患者死亡率总体低于武汉市。重要的是，除了呼吸问题，我们还发现了新型冠状病毒肺炎的肝脏、肾脏、消化道和心脏损伤。将胸部ct图像与咽拭子样本的qPCR分析相结合，可以提高新型冠状病毒肺炎诊断的准确性。
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.