Epidemiological and clinical characteristics of 65 hospitalized patients with COVID-19 in Liaoning, China

摘要

BACKGROUND Coronavirus disease 2019(COVID-19)has spread rapidly to multiple countries through its infectious agent severe acute respiratory syndrome coronavirus 2.The severity,atypical clinical presentation,and lack of specific anti-viral treatments have posed a challenge for the diagnosis and treatment of COVID-19.Understanding the epidemiological and clinical characteristics of COVID-19 cases in different geographical areas is essential to improve the prognosis of COVID-19 patients and slow the spread of the disease.AIM To investigate the epidemiological and clinical characteristics and main therapeutic strategy for confirmed COVID-19 patients hospitalized in Liaoning Province,China.METHODS Adult patients(n=65)with confirmed COVID-19 were enrolled in this retrospective study from January 20 to February 29,2020 in Liaoning Province,China.Pharyngeal swabs and sputum specimens were collected from the patients for the detection of severe acute respiratory syndrome coronavirus 2 nucleic acid.Patient demographic information and clinical data were collected from the medical records.Based on the severity of COVID-19,the patients were divided into nonsevere and severe groups. All patients were followed until March 20,2020.RESULTSThe mean age of 65 COVID-19 patients was 45.5 ± 14.4 years, 56.9% were men,and 24.6% were severe cases. During the 14 d before symptom onset, 25 (38.5%)patients lived or stayed in Wuhan, whereas 8 (12.3%) had no clear history ofexposure. Twenty-nine (44.6%) patients had at least one comorbidity;hypertension and diabetes were the most common comorbidities. Compared withnonsevere patients, severe patients had significantly lower lymphocyte counts[median value 1.3 × 109/L (interquartile range 0.9-1.95) vs 0.82 × 109/L (0.44-1.08),P < 0.001], elevated levels of lactate dehydrogenase [450 U/L (386-476) vs 707 U/L(592-980), P < 0.001] and C-reactive protein [6.1 mg/L (1.5-7.2) vs 52 mg/L (12.7-100.8), P < 0.001], and a prolonged median duration of viral shedding [19.5 d (16-21) vs 23.5 d (19.6-30.3), P = 0.001]. The overall median viral shedding time was19.5 d, and the longest was 53 d. Severe patients were more frequently treatedwith lopinavir/ritonavir, antibiotics, glucocorticoid therapy, immunoglobulin,thymosin, and oxygen support. All patients were discharged following treatmentin quarantine.CONCLUSIONOur findings may facilitate the identification of severe cases and inform clinicaltreatment and quarantine decisions regarding COVID-19.