Clinical features of coronavirus disease 2019 in Northeast area of Chongqing: analysis of 143 cases

Abstract

Objective To explore the clinical features of 143 patients suffering from coronavirus disease 2019 (COVID-19) in the Northeast area of Chongqing. Methods A total of 143 COVID-19 patients who were positive to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by nucleic acid test in nasopharyngeal swab and had typical CT characteristics of the novel coronavirus-infected pneumonia from Jan. 23 to Feb. 8 in 2020 were recruited in this study. Their epidemiology and clinical features were collected and retrospectively analyzed. And the differences in laboratory results were compared among the groups of different clinical classification. The treatment and clinical outcomes were also analyzed. Results Among the 143 patients with confirmed COVID-19, 76 of them (76/143, 53.1%) came from the epidemic area, Wuhan, 52 (36.4%) had the contact history with the infected cases, and 15(10.5%) had no contact history of with those from epidemic areas. According to their conditions, they were assigned into ordinary group (n=107, 74.8%), severe group (n=24, 16.8%) and critical group (n=12, 8.4%). Their main clinical symptoms were fever, cough, headache and fatigue. And, 11 patients had no clinical symptoms. The most common comorbidities were hypertension and diabetes, followed by chronic gastritis, hepatitis B and tuberculosis. Laboratory results indicated that the patients with decreased WBC accounted for 25.8%, and those with decreased for 44.8% in all the patients. The more severe the condition was, the lower lymphocyte count was decreased, and significant differences were seen in the count among the 3 groups (P < 0.05). The serum levels of C-reactive protein (CRP), procalcitonin (PCT) and IL-6 rose when compared with the normal levels, and the increments were associated with the severity of the disease, with statistical difference among the 3 groups (P < 0.05). Conclusion No specific manifestations are identified in COIVD-19, and some patients may have no symptoms. But chest abnormal views of multiple macular patches and interstitial changes could be observed in early stage of this disease. For those who have contact history with the infected or suspected, nucleic acid test and chest radiology should be performed as early as possible. The absolute decrease of peripheral blood lymphocyte count is an index for the severity and prognosis of the disease. The dynamic follow-up of CRP, IL-6 and PCT can be used to make prediction for severe disease in the early stage and be helpful in guidance of treatment. Complicated metabolic and cardiovascular diseases are the risk factors for poor prognosis.

Keywords

• coronavirus disease 2019
• chongqing city
• coronavirus
• clinical features