Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China

Abstract

Background: In late December 2019, an outbreak of acute respiratory illness, coronavirus disease 2019 (COVID-19), emerged in Wuhan, China. We aimed to study the epidemiology, clinical features and short-term outcomes of patients with COVID-19 in Wuhan, China.

Methods: We performed a single center, retrospective case series study in 221 patients with laboratory confirmed SARS-CoV-2 pneumonia at a university hospital, including 55 severe patients and 166 non-severe patients, from January 2, 2020 to February 10, 2020.

Results: Of the 221 patients with COVID-19, the median age was 55.0 years and 48.9% were male and only 8 (3.6%) patients had a history of exposure to the Huanan Seafood Market. Compared to the non-severe pneumonia patients, the median age of the severe patients was significantly older, and they were more likely to have chronic comorbidities. Most common symptoms in severe patients were high fever, anorexia and dyspnea. On admission, 33.0% patients showed leukopenia and 73.8% showed lymphopenia. In addition, the severe patients suffered a higher rate of co-infections with bacteria or fungus and they were more likely to developing complications. As of February 15, 2020, 19.0% patients had been discharged and 5.4% patients died. 80% of severe cases received ICU (intensive care unit) care, and 52.3% of them transferred to the general wards due to relieved symptoms, and the mortality rate of severe patients in ICU was 20.5%.

Conclusions: Patients with elder age, chronic comorbidities, blood leukocyte/lymphocyte count, procalcitonin level, co-infection and severe complications might increase the risk of poor clinical outcomes.

Fig. 1

Transverse chest CT images of the patients with COVID-19. Case A: Transverse chest CT images from a 72-year-old man severely affected with severe COVID-19. The first chest CT shows multiple ground-glass opacities in bilateral lungs on day 8 after symptom onset. The second chest CT shows progressive bilateral ground-glass opacities and multiple lobes of consolidation on day 14 after symptom onset, and the third CT image was obtained after ECMO supportive therapy in the ICU showing recovery status on day 30 after symptom onset. Case B: Transverse chest CT images from a 44-year-old man with mild COVID-19. The first chest CT shows bilateral multiple lobular and subsegmental areas of consolidation on day 7 after symptom onset. The second chest CT shows bilateral ground-glass opacity and subsegmental areas of consolidation on day 10 after symptom onset, and the third chest CT shows improved status on day 18 after symptom onset.