Clinical characteristics of 199 discharged patients with COVID-19 in Fujian Province: A multicenter retrospective study between January 22nd and February 27th, 2020

Abstract

Background: Coronavirus disease 2019 (COVID-19) has quickly spread throughout the country and the world since first broke out in Wuhan, China. The outbreak that started from January 22, 2020, in Fujian Province has been controlled as the number of indigenous cases has not increased since March. We aimed to describe the clinical characteristics of patients with COVID-19 in Fujian Province, China.

Methods: In this retrospective, multicenter study, we collected and analyzed the epidemiological, clinical, and laboratory data of all cases confirmed by nucleic acid tests in five designated hospitals in Fujian Province between January 22 and February 27, 2020. All patients were followed up until discharge. COVID-19 severity was classified as mild, moderate, severe, or critical.

Results: Of 199 discharged patients with COVID-19, 105 patients were male, with a median age of 46.3 years, and 17 patients were severe, and 5 patients were critical on admission. Hypertension and diabetes were the most common comorbidities. The symptoms at illness onset were mainly fever (76.4%), cough (60.8%), and myalgia or fatigue (27.6%). A total of 96.5% of patients had abnormal imaging findings on chest computed tomography. Lymphopenia (37.2%) and hypoxemia (13.6%) were observed. Acute respiratory distress syndrome and respiratory failure occurred in 9 patients (4.5%) and 8 patients (4.0%) respectively. One patient died and the others were cured and discharged with the median hospital stay of 19 days. Old age was negatively correlated with lymphocyte count (r = - 0.296, p < 0.001) and oxygenation index (r = - 0.263, p = 0.001). Bivariate regression analysis revealed that old age (≥ 75 years), hypertension, diabetes, and lymphopenia were correlated with the severity of COVID-19.

Conclusions: Patients in Fujian Province were mostly nonsevere cases with mild or moderate symptoms, and had a lower mortality than patients in Wuhan (4.3%-15%). Older age, hypertension, diabetes, and lymphopenia were risk factors for severity of COVID-19.

Fig 1. Age distributions, clinical classifications and correlations of age, lymphocyte count, and oxygenation index in patients with COVID-19.

In different age groups, (A) number of confirmed patients and the distribution of four clinical classifications, and (B) correlations between age and blood lymphocyte number and (C) oxygenation index on admission in all patients.

Fig 2. Representative thoracic CT images.

(A) CT images from a 71-year-old woman showing bilateral focal ground-glass opacities (GGOs) close to subpleural at day 3 after illness onset and (B) multiple patchy shadows with increasing GGOs at day 10 after illness onset. (C) CT images of a 48-year-old man showing bilateral patchy shadows and multiple GGOs at day 9 after illness onset; (D) the GGOs were absorbed mostly leaving linear opacities or fibrous stripes at day 18 after illness onset.