Epidemiological, Clinical Characteristics and Outcome of Medical Staff Infected with COVID-19 in Wuhan, China: A Retrospective Case Series Analysis

Abstract

Backgrounds Since December 2019, a novel coronavirus epidemic has emerged in Wuhan city, China and then rapidly spread to other areas. As of 20 Feb 2020, a total of 2,055 medical staff confirmed with coronavirus disease 2019 (COVID-19) caused by SARS-Cov-2 in China had been reported. We sought to explore the epidemiological, clinical characteristics and prognosis of novel coronavirus-infected medical staff. MethodsIn this retrospective study, 64 confirmed cases of novel coronavirus-infected medical staff admitted to Union Hospital, Wuhan between 16 Jan, 2020 to 15 Feb, 2020 were included. Two groups concerned were extracted from the subjects based on duration of symptoms: group 1 (≤10 days) and group 2 (>10 days). Epidemiological and clinical data were analyzed and compared across groups. The Kaplan-Meier plot was used to inspect the change in hospital discharge rate. The Cox regression model was utilized to identify factors associated with hospital discharge. FindingsThe median age of medical staff included was 35 years old. 64% were female and 67% were nurses. None had an exposure to Huanan seafood wholesale market or wildlife. A small proportion of the cohort had contact with specimens (5%) as well as patients in fever clinics (8%) and isolation wards (5%). Fever (67%) was the most common symptom, followed by cough (47%) and fatigue (34%). The median time interval between symptoms onset and admission was 8.5 days. On admission, 80% of medical staff showed abnormal IL-6 levels and 34% had lymphocytopenia.Chest CT mainly manifested as bilateral (61%), septal/subpleural (80%) and ground-glass (52%) opacities. During the study period, no patients was transferred to intensive care unit or died, and 34 (53%) had been discharged. Higher body mass index (BMI) (≥ 24 kg/m 2 ) (HR 0.14; 95% CI 0.03-0.73), fever (HR 0.24; 95% CI 0.09-0.60) and higher levels of IL-6 on admission (HR 0.31; 95% CI 0.11-0.87) were unfavorable factors for discharge. : medRxiv preprint medical expertise, younger age and less underlying diseases. Smaller BMI, absence of fever symptoms and normal IL-6 levels on admission are favorable for discharge for medical staff. Further studies should be devoted to identifying the exact patterns of SARS-CoV-2 infection among medical staff.

Interleukin-6 as a potential biomarker of COVID-19 progression

“…We initially identified 73 articles based on our search strategy, 64 of which were excluded after title, abstract, or full-text reading, because they were review articles, did not report IL-6 levels, or did not classify the condition of COVID-19 patients as non-severe and severe. Finally, only nine studies were included in this meta-analysis [1][2][3][4][5][6][7][8][9]. Although the heterogeneity was considerably high (I 2 = 89%; P < 0.00001), we observed that IL-6 levels were significantly increased in COVID-19-infected patients with severe condition compared with those with non-severe condition (SMD = 0.71, 95%CI −0.31-1.12, P = 0.0005) ( Fig.…”

Prevalence of SARS-CoV-2 infection in previously undiagnosed health care workers at the onset of the U.S. COVID-19 epidemic

“…On the frontlines of defense against the virus, HCW may experience increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to close contact with highly infectious patients 1 and, commonly, insufficient access to personal protective equipment (PPE) 2 . The plight of HCW during the pandemic has been widely noted [3][4][5][6][7][8] ; as of April 9, 2020, 9,282 known COVID-19 cases among U.S. HCW had been reported to the Centers for Disease Control and Prevention (CDC) 9 . Of HCW with COVID-19, 55% reported that their only known exposure was the in the health care setting.…”

A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications

“…Until recently [39], no firm conclusions could be drawn from studies evaluating the rates of current smokers in Covid-19. All these studies [40][41][42][43][44][45][46][47][48], although reporting low rates of current smokers, ranging from 1.4 % to 12.5 %, did not take into account the main potential confounders of smoking including age and sex. In the study that two of us are reporting [1], the rates of current smoking remain below 5 % even when main confounders for tobacco consumption, i.e.…”