Yixue xinzhi zazhi (Oct 2020)
The cross-sectional study of hospitalized COVID-19 patients in Xiangyang, Hubei province
Abstract
Objective To study the epidemiological and clinical characteristics of the Corona Virus Disease 2019 (COVID-19) hospitalized patients in Xiangyang No.1 people’s hospital, to offer suggestions to the urgent needs of COVID-19 prevention, diagnosis and treatment.Methods In this study, all the confirmed cases in Xiangyang No.1 people’s hospital were included until Feb 9, 2020. After all data were extracted and analyzed, we summarized the COVID-19 patients epidemiological and clinical features.Results 102 cases were confirmed by real-time RT-PCR, including 52 males and 50 females with an average age of 50.38 years (SD 16.86). We found 7 imported cases and 37 patients with travel history to Wuhan while rest are secondary cases such as family clustered infections. Incubation time of COVID-19 ranges from 1 day up to 20 days, average period was 8.09 days (SD 4.99). Fever (84%), cough (57%), fatigue (27%), shortness of breath (23%), diarrhea (15%), expectoration (12%), inappetence (10%) were the most common clinical manifestations. According to the laboratory findings, 21 patients showed decreased blood leukocyte count and lymphopenia was observed in 56 patients. 66 (66/97) patients showed elevated C-reactive protein level, 49 (49/85) patients had increased erythrocytes sedimentation rate. Higher level of procalcitonin and ferritin were observed in 19 (19/72) and 12 (12/13) patients, respectively. Anti-viral and anti-inflammatory treatments were taken on all patients according to their symptoms. Among all hospitalized patients, 8 were admitted to intensive care unit (ICU), 6 developed respiratory failure and 3 had multiple organ failure. 3 death were recorded by Feb 10, 2020. 90 patients were found with typical radiological findings of pneumonia on chest computed tomography (CT) for first examination and this number increased to 100 in second CT scan as a consistency of 98% with rea-time RT-PCR diagnosis. When retrospected to the first real-time RT-PCR examination, which showed 66% positive rate while the following second and third test showed 86% and 96% cumulative positive rate among all included patients, respectively.Conclusions Most COVID-19 patients in Xiangyang were identified as secondary cases, some cases had long incubation period, no significant difference of susceptibility was found between genders, middle-to-old-age population were sensitive to SARS-CoV-2 infection, severe and fatal cases mainly came from patients over 70 years old. For the mentioned phenomenon, special interventions need to be taken. Some parameters like ferritin could be used as possible clinical markers of COVID-19 associated inflammation. The low rate of severe cases and low mortality could be due to active prevention after the outbreak and relative adequate access to medical resources. Repeated real-time RT-PCR for 3 times together with 2 times of CT scans and symptoms could give significantly higher positive rate than single examination, benefits the COVID-19 prevention, diagnosis and treatment.
Keywords
