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Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China Bo Hu  1 , Chang Hu  1 , Fangfang Zhu  1 , Xing Liu  1 , Jing Zhang  1 , Binbin Wang  1 , Hui Xiang  1 , Zhenshun Cheng  2 , Yong Xiong  3 , Yan Zhao  4 , Yirong Li  5 , Xinghuan Wang  6 , Zhiyong Peng  1

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Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

Dawei Wang et al. JAMA. 2020.

. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. Authors Dawei Wang  1 , Bo Hu  1 , Chang Hu  1 , Fangfang Zhu  1 , Xing Liu  1 , Jing Zhang  1 , Binbin Wang  1 , Hui Xiang  1 , Zhenshun Cheng  2 , Yong Xiong  3 , Yan Zhao  4 , Yirong Li  5 , Xinghuan Wang  6 , Zhiyong Peng  1 Affiliations

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Erratum in Abstract

Importance: In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

Objective: To describe the epidemiological and clinical characteristics of NCIP.

Design, setting, and participants: Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020.

Exposures: Documented NCIP.

Main outcomes and measures: Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked.

Results: Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0).

Conclusions and relevance: In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.. Chest Computed Tomographic Images of…

Figure 1.. Chest Computed Tomographic Images of a 52-Year-Old Patient Infected With 2019 Novel Coronavirus…

 Figure 1.. Chest Computed Tomographic Images of a 52-Year-Old Patient Infected With 2019 Novel Coronavirus (2019-nCoV)

A, Chest computed tomographic images obtained on January 7, 2020, show ground glass opacity in both lungs on day 5 after symptom onset. B, Images taken on January 21, 2020, show the absorption of bilateral ground glass opacity after the treatment of extracorporeal membrane oxygenation from January 7 to 12 in the intensive care unit.

Figure 2.. Dynamic Profile of Laboratory Parameters…

Figure 2.. Dynamic Profile of Laboratory Parameters in 33 Patients With Novel Coronavirus–Infected Pneumonia (NCIP)

 Figure 2.. Dynamic Profile of Laboratory Parameters in 33 Patients With Novel Coronavirus–Infected Pneumonia (NCIP)

Timeline charts illustrate the laboratory parameters in 33 patients with NCIP (5 nonsurvivors and 28 survivors) every other day based on the days after the onset of illness. The solid lines in black show the upper normal limit of each parameter, and the solid line in red shows the lower normal limit of lymphocyte count. aP < .05 for nonsurvivors vs survivors.

Comment in Similar articles Cited by References
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