Clinical Characteristics of 138 Hospitalized PatientsWith 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China
IMPORTANCE In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP)occurred in Wuhan, China. The number of cases has increased rapidly but information on theclinical characteristics of affected patients is limited
OBJECTIVE To describe the epidemiological and clinical characteristics of NCIP.
DESIGN, SETTING, AND PARTICIPANTS Retrospective, single-center case series of the 138consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of WuhanUniversity in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up wasFebruary 3, 2020.
MAIN OUTCOMES AND MEASURESE pidemiological, demographic, clinical, laboratory,radiological, and treatment data were collected and analyzed. Outcomes of critically illpatients and noncritically ill patients were compared. Presumed hospital-related transmissionwas suspected if a cluster of health professionals or hospitalized patients in the same wardsbecame infected and a possible source of infection could be tracked.
RESULT SOf 138 hospitalized patients with NCIP, the median age was 56 years (interquartilerange, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associatedtransmission was suspected as the presumed mechanism of infection for affected healthprofessionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptomsincluded fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]).Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients(39.9%). Chest computed tomographic scans showed bilateral patchy shadows orground glass opacity in the lungs of all patients. Most patients received antiviral therapy(oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89[64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy(62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU)because of complications, including acute respiratory distress syndrome (22 [61.1%]),arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom todyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days.Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102),were older (median age, 66 years vs 51 years), were more likely to have underlyingcomorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%]vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%)received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17(47.2%) received invasive ventilation (4 were switched to extracorporeal membraneoxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overallmortality, 4.3%), but the remaining patients are still hospitalized. Among those dischargedalive (n = 47), the median hospital stay was 10 days
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