Background: In December 2019, a cluster of coronavirus Disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China. With the advent of the Chinese Spring Festival, this disease spread rapidly throughout the country. The information about the clinical characteristics of COVID-19 patients outside of Wuhan is limited.Methods: All of the patients with confirmed COVID-19 were admitted to the First Hospital of Changsha City, the designated hospital for COVID-19 assigned by the Changsha City Government. The clinical and epidemiological characteristics, data of laboratory, radiological picture, treatment, and outcomes records of 201 COVID-19 patients were collected using electronic medical records.Results: This study population consisted of 201 hospitalized patients with laboratory-confirmed COVID-19 in Changsha by April 28, 2020. The median age of the patients was 45 years (IQR 34–59). About half (50.7%) of the patients were male, and most of the infected patients were staff (96 [47.8%]). Concerning the epidemiologic history, the number of patients linked to Wuhan was 92 (45.8%). The most common symptoms were fever (125 [62.2%]), dry cough (118 [58.7%]), fatigue (65 [32.3%]), and pharyngalgia (31 [15.4%]). One hundred and forty-four (71.6%) enrolled patients showed bilateral pneumonia. Fifty-four (26.9%) patients showed unilateral involvement, and three (1.5%) patients showed no abnormal signs or symptoms. The laboratory findings differed significantly between the Intensive Care Unit (ICU) and non-ICU groups. Compared with non-ICU patients, ICU patients had depressed white blood cell (WBC), neutrocytes, lymphocytes, and prolonged prothrombin time (PT). Moreover, higher plasma levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALA), aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase-MB (CK-MB), creatinine (CREA), and lactate dehydrogenase (LDH) were detected in the ICU group.Conclusions: In this single-center study of 201 COVID-19 patients in Changsha, China, 22.4% of patients were admitted to ICU. Based on our findings, we propose that the risk of cellular immune deficiency, hepatic injury, and kidney injury should be monitored. Previous reports focused on the clinical features of patients from Wuhan, China. With the global epidemic of COVID-19, we should pay more attention to the clinical and epidemiological characteristics of patients outside of Wuhan.
Background:Little is known about the dynamic changes in the patient immune responses to SARS-CoV-2, and how different responses are correlated with disease severity and outcomes.Method:A total of 74 patients with confirmed COVID-19 were included from January 29th to February 15th 2020. Clinical characteristics and dynamic changes in immune response were analyzed and compared between severe and non-severe patients. ResultsOf the 74 patients, 17 suffered from severe disease and 57 from non-severe disease. Patients with severe disease tended be older (65.29 ± 12.33 years vs. 45.37 ± 18.66 years), and had a greater degree of underlying disease (41.18% vs. 24.56%) , lower lymphocytes counts (0.69 ± 0.36 × 10⁹ vs. 1.46 ± 0.75 × 10⁹) , higher neutrophil-lymphocyte-ratios (NLRs; 3.76 (3.15–5.51) vs. 2.07 (1.48–2.93)) and lower eosinophil counts (0.01 ± 0.01 × 10⁹ vs. 0.05 ± 0.07 × 10⁹), than that in non-severe patients. The number of immune cell subtypes, including helper T cells, suppressor T cells, B cells, and natural killer cells was significantly decreased in severe cases compared to that in non-severe cases (335.47 vs. 666.46/mL; 158 vs. 334/mL; 95 vs. 210/mL; 52 vs. 122/mL, respectively). As the condition of the patients improved, the number of neutrophils decreased significantly in the severe patients. All patients who recovered exhibited a gradual and persistent increase in eosinophil counts and lymphocyte counts, including helper T cells, suppressor T cells, and natural killer cells. In addition, the levels of most of inflammatory cytokines, including IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF–α generally decreased as the patients gradually recovered.ConclusionsCollectively, our study provides novel information on the kinetics of the immune responses to COVID-19. Furthermore, our study indicates that both innate and adaptive immune responses correlate with better clinical outcomes.
Background:The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout China and all over the world. Little is known about the dynamic changes in the patient immune responses to SARS-CoV-2, and how different responses are correlated with disease severity and outcomes.Method:74 patients with confirmed COVID-19 were enrolled in this prospective research. The demographic information, medical history, symptoms, signs and laboratory results were analyzed and compared between severe and non-severe patients. The leukocytes, lymphocyte subsets and inflammatory cytokines were longitudinally collected.Results:Of the 74 patients included, 17 suffered from severe disease. The severe patients tended be older (65.29 ± 12.33 years vs. 45.37 ± 18.66 years), and had a greater degree of underlying disease (41.18% vs. 24.56%) , lower baseline lymphocytes counts (0.69 ± 0.36 × 10⁹ vs. 1.46 ± 0.75 × 10⁹) , higher neutrophil-lymphocyte-ratios (NLRs; 3.76 (3.15–5.51) vs. 2.07 (1.48–2.93)) and lower baseline eosinophil counts (0.01 ± 0.01 × 10⁹ vs. 0.05 ± 0.07 × 10⁹), than that in non-severe patients. The baseline helper T (Th) cells (335.47 vs. 666.46/mL), suppressor T(Ts) cells (158 vs. 334/mL), B cells (95 vs. 210/mL), and natural killer (NK) cells (52 vs. 122/mL) were significantly decreased in severe cases compared to that in non-severe cases. In addition, the baseline neutrophils and B cells were positively correlated with the severity of COVID-19 and the baseline lymphocytes and Th cells were negatively correlated with the severity of COVID-19. The dynamic change of T cells, Th cells and IFN-γ in the severe cases were parallel to the amelioration of the disease.Conclusions:Collectively, our study provides novel information on the kinetics of the immune responses in a cohort of COVID-19 patients with different disease severities. Furthermore, our study indicates that both innate and adaptive immune responses correlate with better clinical outcomes.
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