Clinical Features and Short-term Outcomes of 102 Patients with Coronavirus Disease 2019 in Wuhan, China
Clinical Features and Short-term Outcomes of 102 Patients with Coronavirus Disease 2019 in Wuhan, China
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DOI：
10.1093/cid/ciaa243
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发表时间：
2020-08-01
影响因子：
11.8
通讯作者：
Liu, Qiang
中科院分区：
文献类型：
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作者：
Cao, Jianlei;Tu, Wen-Jun;Liu, Qiang
背景2019年12月，中国湖北武汉出现了一系列不明原因的肺炎病例。在这项研究中，我们调查了2019冠状病毒病（COVID-19）患者的临床和实验室特征以及短期结局。所有于2020年1月3日至2月1日期间在中国武汉大学中南医院住院的COVID-19患者均纳入研究。所有这些患者都有实验室确诊的感染。收集了流行病学、临床和放射学特征、基础疾病、实验室检查、治疗、并发症和结局数据。出院时随访结局至2020年2月15日。研究队列包括102例成人患者。中位年龄为54岁（四分位数范围，37-67岁），48.0%为女性。共有34名患者（33.3%）在医院环境中暴露于传播源（作为卫生保健工作者，患者或访客），10名患者（9.8%）有家族聚集性。有18例患者（17.6%）入住重症监护室（ICU），17例患者死亡（死亡率，16.7%; 95%置信区间，9.4-23.9%）。那些幸存的患者更年轻，更可能是卫生保健工作者，并且不太可能患有合并症。他们也不太可能患有并发症。存活组和非存活组的药物治疗率没有差异。存活的患者不太可能需要入住ICU（14.1% vs 35.3%）。胸部影像学检查显示死亡患者更可能有磨玻璃样阴影（41.2% vs存活者12.9%）。在我们的队列中描述的符合我们纳入本分析标准的COVID-19患者中，死亡率较高。在死亡患者中更常见的患者特征是疾病发作后发生全身性并发症和需要入住ICU的疾病严重程度。我们的数据支持其他人的描述，即COVID-19感染是由人际传播（包括病例的家族聚集性）和医院传播引起的。接受或未接受抗微生物或糖皮质激素药物治疗的患者死亡率无差异。
Background. In December 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China. In this study, we investigate the clinical and laboratory features and short-term outcomes of patients with coronavirus disease 2019 (COVID-19).Methods. All patients with COVID-19 admitted to Wuhan University Zhongnan Hospital in Wuhan, China, between 3 January and 1 February 2020 were included. All those patients were with laboratory-confirmed infections. Epidemiological, clinical, and radiological characteristics; underlying diseases; laboratory tests; treatments; complications; and outcomes data were collected. Outcomes were followed up at discharge until 15 February 2020.Results. The study cohort included 102 adult patients. The median age was 54 years (interquartile ranger, 37-67 years), and 48.0% were female. A total of 34 patients (33.3%) were exposed to a source of transmission in the hospital setting (as health-care workers, patients, or visitors) and 10 patients (9.8%) had a familial cluster. There were 18 patients ( 17.6%) who were admitted to the intensive care unit (ICU), and 17 patients died (mortality, 16.7%; 95% confidence interval, 9.4-23.9%). Those patients who survived were younger, were more likely to be health-care workers, and were less likely to suffer from comorbidities. They were also less likely to suffer from complications. There was no difference in drug treatment rates between the survival and nonsurvival groups. Those patients who survived were less likely to require admission to the ICU (14.1% vs 35.3% of those admitted). Chest imaging examinations showed that patients who died were more likely to have ground-glass opacity (41.2% vs 12.9% in survivors).Conclusions. The mortality rate was high among the COVID-19 patients described in our cohort who met our criteria for inclusion in this analysis. The patient characteristics seen more frequently in those who died were the development of systemic complications following onset of the illness and a severity of disease requiring admission to the ICU. Our data support those described by others indicating that COVID-19 infection results from human-to-human transmission, including familial clustering of cases, and from nosocomial transmission. There were no differences in mortality among those who did or did not receive antimicrobial or glucocorticoid drug treatments.