Clinical characteristics and follow-up analysis of 324 discharged COVID-19 patients in Shenzhen during the recovery period

Abstract

Objectives: Research on recovering COVID-19 patients could be helpful for containing the pandemic and developing vaccines, but we still do not know much about the clinical features, recovery process, and antibody reactions during the recovery period. Methods: We retrospectively analysed the epidemiological information, discharge summaries, and laboratory results of 324 patients. Results: In all, 15 (8.62%) patients experienced chest distress/breath shortness, where 8 of the 15 were severely ill. This means severely ill patients need an extended amount of time to recover after discharge; next, 20 (11.49%) patients experienced anxiety and 21 (12.07%) had headache/insomnia and a small fraction of them complained of anosmia/ageusia, indicating that these patients need treatment for mental and psychological health issues. Regarding the re-positive patients, their CT and laboratory test results showed no obvious evidence of illness progress or infectivity but a high anti-SARS-CoV-2 antibody expression. Conclusion: Recovered COVID-19 patients need psychological and physiological care and treatment, re-positivity can occur in any person, but juveniles, females, and patients with mild/moderate existing symptoms have higher rates of re-positivity, While there is no evidence that turning re-positive has an impact on their infectivity, but it still alerted us that we need differentiate them in the following managements.

Keywords: Covid-19; antibody; epidemiology; vaccine.

Figure 1

Cohort information. There were 472 confirmed CoVID-19 patients (423 native and 49 imported) and 20 asymptomatic carriers (12 native and 8 imported) in total. 207 of the 472 were discharged before February 21^st (line black), 168 of the 207 were non-re-positives and were not involved in the study (line Grey).There were 92 re-positives in total, 45 of them turned re-positive during medical observation (line yellow), 8 of them turned re-positive at community test after medical isolation observation (line blue), and 39 cases discharged before February 21^st and found re-positive in community test (line violet).

Figure 2

Antibody and blood biochemical indexes changed in re-positive patients during recovery A. The comparison of antibody levels against SARS-CoV-2 among 190 none re-positive recovered COVID-19 patients and 78 re-positives, the average S/CO values of total Ab, IgA, IgG, and IgM were compared between re-positives (green) and none re-positives (red). B. The comparison of chest CT score among 89 none re-positive recovered COVID-19 patients and 37 re-positives; the average total scores were compared between re-positives (green) and none re-positives (red). C. Correlations among WBC, neut, lym, and lym abs during stages 1 to 4. D. The trend line of antibody and blood biochemical indexes during the four stages.

Figure 2

Antibody and blood biochemical indexes changed in re-positive patients during recovery A. The comparison of antibody levels against SARS-CoV-2 among 190 none re-positive recovered COVID-19 patients and 78 re-positives, the average S/CO values of total Ab, IgA, IgG, and IgM were compared between re-positives (green) and none re-positives (red). B. The comparison of chest CT score among 89 none re-positive recovered COVID-19 patients and 37 re-positives; the average total scores were compared between re-positives (green) and none re-positives (red). C. Correlations among WBC, neut, lym, and lym abs during stages 1 to 4. D. The trend line of antibody and blood biochemical indexes during the four stages.

Figure 3

Patient age distribution. A. The kernel density plot based on age distribution data. B. COVID-19 proportion taken by different types of patients in different age stages. A, asymptomatic carriers; M, mild and moderate cases; S, severe /critically ill cases.