Clinical Characteristics of Patients with 2019 Coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study

Abstract

Background: Since December, 2019, the 2019 Coronavirus disease (COVID-19) from Wuhan, China, has caused worldwide outbreak with more than 200,000 people infected and thousands of deaths. The clinical characteristics of COVID-19 patients in non-Wuhan areas of Hubei province 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 (33.0%) cases were severe and two (2.2%) patients died. The severe patients tended to be older (50.5 vs 42.0, P=0.049), and have more chronic disease (40% vs 14.75%, P=0.009), compared to mild group. Only 73.6% of the patients were quantitative polymerase chain reaction (qPCR) positive on their first tests, while typical chest computed tomographic (CT) images were obtained for each patient. The most common complaints were cough (75, 82.4%), fever (59, 64.8%), fatigue (35, 38.5%), and diarrhea (14, 15.4%). Non-respiratory injur y was identified by elevated levels of aspartate aminotransferase (18, 19.8%), creatinine (5, 5.5%) and creatine kinase (14, 15.4%) in laboratory tests. In sum, 28 (30.8%) cases 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 is lower than that of Wuhan. Importantly, we discovered liver, kidney, digestive tract and heart injury in COVID-19 cases besides respiratory problems. Combining Chest CT images with qPCR of throat swab samples would improve the accuracy of COVID-19 diagnose.

Clinical presentation and outcomes of hospitalized adults with COVID‐19: A systematic review

“…Researchers demonstrated that compared with survivors, nonsurvivors were more likely to develop sepsis and multiple organ injuries including acute cardiac injury, ARDS requiring mechanical ventilation, and acute kidney injury requiring dialysis. (Deng, Hu, et al, 2020; Inciardi et al., 2020; Shi, Qin, et al, 2020; Wang, Lu, et al, 2020; Yang et al., 2020a; Zhao, Xu, et al, 2020). Secondary infections (30%) and septic shock (32%) are common among severe COVID‐19 patients (Javanian et al., 2020; Tang et al., 2020).…”

Acute Kidney Injury in COVID-19: The Chinese Experience

“…We performed a meta-analyses using the "meta" package in R software version 3.6.3 (the R Foundation for Statistical Computing, Vienna, Austria). The pooled incidence of AKI in all reported COVID-19 patients from these 26 studies was 6.5% (95% CI 4.1-10.2), with a much higher rate in patients from the ICU (32.5%, 95% CI 21.2-46.3) 8,14,19 than in patients from mixed departments (5.1%, 95% 6,[10][11][12][13][15][16][17][18][20][21][22][23][24][25][26][27][28] (Figure 1a). Studies from Wuhan showed a higher AKI incidence (9.7%, 95% CI 6.2-14.9) than studies from outside Wuhan (2.8%, 95% CI 1.2-6.6%) (Figure 1b).…”

“…This study was supported by grants from the National Natural Science Foundation of The median time was 5 (3, 11) days for admission (n=555), 13 (8,17) for critical illness (n=75), 18 (14,22) for in-hospital AKI (n=21), and 29 (22,38) for death (n=27). Data was presented with median value with 25-75% percentiles.…”

Screening and testing for COVID‐19 before surgery

“…Immunological dysfunction due to COVID-19 can potentially result in the derangement of haematological, hepatic and renal laboratory markers. 18,28,31,39,[41][42][43]46,47,50,52,53,57,61,63,64,[69][70][71][72][73] The immunopathogenesis of SARS-CoV-2 infection is typified by an aggressive inflammatory response, 74 and accordingly, elevated inflammatory markers are common. 18,28,[41][42][43]46,47,50,52,61,63,64,[69][70][71][72] Lymphopaenia and an increased neutrophil to lymphocyte ratio can occur in many patients with SARS-CoV-2 infection.…”