Clinical characteristics and short-term outcomes of patients with coronavirus disease 2019: a retrospective single-center experience of a designated hospital in Poland.
冠状病毒病 2019 患者的临床特征和短期结局: 波兰指定医院的回顾性单中心经验。
- 作者列表："Nowak B","Szymański P","Pańkowski I","Szarowska A","Życińska K","Rogowski W","Gil R","Furmanek M","Tatur J","Zaczyński A","Król Z","Wierzba W
INTRODUCTION:Since the first reported case of coronavirus disease 2019 (COVID‑19) in Poland, the worldwide pandemic has spread throughout the country, leading to many hospital admissions. There has been an urgent need to determine clinical characteristics of Polish patients with laboratory‑confirmed severe acute respiratory syndrome coronavirus 2 (SARS‑CoV 2) infection in the clinical setting. OBJECTIVES:The aim of this retrospective study was to outline characteristics and short‑ term outcomes of SARS‑CoV‑2-positive patients. PATIENTS AND METHODS:We retrospectively assessed 169 consecutive patients with laboratory‑ confirmed COVID‑ 19 with regard to their clinical manifestations, radiological findings, treatment, complications, and outcomes. RESULTS:Of the 169 patients, more than half was aged 65 years or older (88; 52.1%), 51.5% were male, and 78.3% had comorbidities. The majority of patients (106; 62.7%) were transferred from outbreak locations in medical facilities. The most common symptoms on admission were fever (42%), shortness of breath (35%), and fatigue (33%). Twenty seven (15.4%) patients required intensive care unit admission. Overall mortality was 26.3% (n = 46) and was significantly higher in patients transferred from other facilities (38 out of 106; 35.8%), than in patients admitted directly to the hospital (8 out of 63; 12.69%; P <0.001). Seventeen out of 29 patients admitted to the intensive care unit died (mortality, 58.6%), including 30 out of 41 patients with acute respiratory distress syndrome (73.2% mortality rate). CONCLUSIONS:Polish patients with COVID‑19 have similar characteristics and risk factors for adverse outcomes to those observed in countries in which outbreaks occurred earlier. Significantly higher mortality in patients transferred from other centers warrants special attention and transfer policy should be verified.
引言: 自波兰报告首例冠状病毒病 2019 (covid ‑ 19) 以来，全球范围的大流行已经蔓延到全国各地，导致许多住院患者。目前迫切需要确定波兰实验室确诊新型冠状病毒 (sars ‑ cov 2) 感染患者的临床特征。 目的: 本回顾性研究的目的是概述sars ‑ cov ‑ 2 阳性患者的特征和短期结局。 患者和方法: 我们回顾性评估了 169 例实验室-确诊covid-19 的连续患者的临床表现、放射学发现、治疗、并发症和结局。 结果: 在 169 例患者中，超过一半的患者年龄在 65 岁或以上 (88; 52.1%)，51.5% 为男性，78.3% 有合并症。大多数患者 (106; 62.7%) 是从医疗机构的爆发地点转移而来。入院时最常见的症状是发热 (42%) 、气短 (35%) 乏力 33%)。27 例 (15.4%) 患者需要入住重症监护室。总死亡率为 26.3% (n = 46)，从其他机构转移的患者显著较高 (38/106; 35.8%)，比直接入院的患者 (63 例中有 8 例; 12.69%; P <0.001)。29 例重症监护病房患者中 17 例死亡 (病死率 58.6%)，其中 30 例急性呼吸窘迫综合征 (73.2% 死亡率)。 结论: 波兰covid ‑ 19 患者的不良结局特征和危险因素与在暴发较早的国家观察到的相似。从其他中心转移的患者死亡率显著升高值得特别关注，转移政策应得到验证。
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.