Clinical Features of Patients Infected with the 2019 Novel Coronavirus (COVID-19) in Shanghai, China

Abstract

Background: Since mid-December 2019, a cluster of pneumonia-like diseases caused by a novel coronavirus, now designated COVID-19 by the WHO, emerged in Wuhan city and rapidly spread throughout China. Here we identify the clinical characteristics of COVID-19 in a cohort of patients in Shanghai.Methods: Cases were confirmed by real-time RT-PCR and were analysed for demographic, clinical, laboratory and radiological features. Results:Of 198 patients, the median duration from disease onset to hospital admission was 4 days. The mean age of the patients was 50.1 years, and 51.0% patients were male. The most common symptom was fever. Less than half of the patients presented with respiratory systems including cough, sputum production, itchy or sore throat, shortness of breath, and chest congestion. 5.6% patients had diarrhoea. On admission, T lymphocytes were decreased in 45.8% patients. Ground glass opacity was the most common radiological finding on chest computed tomography. 9.6% were admitted to the ICU because of the development of organ dysfunction. Compared with patients not treated in ICU, patients treated in the ICU were older, had longer waiting time to admission, fever over 38.5 o C, dyspnoea, reduced T lymphocytes, elevated neutrophils and organ failure. Conclusions:In this single centre cohort of COVID-19 patients, the most common symptom was fever, and the most common laboratory abnormality was decreased blood T cell counts. Older age, male, fever over 38.5 o C, symptoms of dyspnoea, and underlying comorbidity, were the risk factors most associated with severity of disease. MethodsPatients. We obtained epidemiological, demographic, clinical, laboratory and management data from the medical records of patients infected with SARS-Cov-2. On Jan 20, 2020, the first human case of in Shanghai was confirmed. Since then all hospitals in Shanghai have opened special fever clinics to screen suspected patients, and laboratory confirmed patients were then admitted to a single designated hospital in Shanghai (Shanghai Public Health Clinical Centre). Laboratory confirmation of COVID-19 was done by the Chinese Centre for Disease Control and Prevention. Throat-swab specimens from the upper respiratory tract were obtained from all patients at admission and maintained in viral transport medium. COVID-19 was confirmed by real-time RT-PCR using the same protocol as described previously 3 . Confirmed patients were hospitalized into negative pressure wards for further medical observation and treatment. We collected data from patients who were admitted from Jan. 20 up to Feb. 15. All the data collected from the included cases have been shared with the WHO. Data Collection. Epidemiological exposure data, patient characteristics, clinical symptoms, laboratory and imaging findings and medical history were extracted from electronic medical records and analysed by licensed physicians. Laboratory data were recorded in standardized form. Initial investigations included a complete blood count, routine urinalysis, blood gases, coagulation...

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