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Published on: December 19, 2020
Epidemiological and clinical features of 201 COVID-19 patients in Changsha city, Hunan, China
Jian Zhou1, Jingjing Sun2,3, Ziqin Cao1
1Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan.
Insights
This study analyzed 201 coronavirus Disease 2019 (COVID-19) patients in Changsha, China, detailing clinical characteristics and laboratory findings. Findings suggest monitoring for immune, liver, and kidney injuries in COVID-19 patients outside Wuhan.
Area of Science:
- Infectious Diseases
- Epidemiology
- Clinical Medicine
Background:
- Coronavirus Disease 2019 (COVID-19) emerged in Wuhan, China, in December 2019.
- Understanding COVID-19 clinical features beyond Wuhan is crucial for global pandemic response.
- This study focuses on patients from Changsha, a major city outside the initial outbreak epicenter.
Purpose of the Study:
- To describe the clinical and epidemiological characteristics of hospitalized COVID-19 patients in Changsha, China.
- To analyze laboratory findings and identify differences between intensive care unit (ICU) and non-ICU patients.
- To highlight potential risks for cellular immune deficiency, hepatic injury, and kidney injury.
Main Methods:
- Retrospective analysis of electronic medical records for 201 laboratory-confirmed COVID-19 patients admitted to a designated hospital in Changsha by April 28, 2020.
- Collection of data on clinical symptoms, epidemiological history, laboratory results, radiological findings, treatment, and outcomes.
- Comparison of laboratory findings between ICU and non-ICU patient groups.
Main Results:
- The study included 201 patients with a median age of 45 years; 45.8% had a history linked to Wuhan.
- Common symptoms included fever (62.2%), dry cough (58.7%), and fatigue (32.3%).
- ICU patients exhibited distinct laboratory profiles, including depressed white blood cell counts, prolonged prothrombin time, and elevated inflammatory markers (ESR, CRP, PCT) and organ injury markers (AST, ALT, CK, LDH, CREA).
- 22.4% of patients required ICU admission.
Conclusions:
- COVID-19 patients outside Wuhan present with characteristic symptoms and radiological findings.
- Significant differences in laboratory results between ICU and non-ICU patients indicate severe disease progression.
- Monitoring for cellular immune deficiency, hepatic injury, and kidney injury is recommended for hospitalized COVID-19 patients.
Abstract:
In December 2019, a cluster of coronavirus Disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China. The present study was conducted to report the clinical characteristics of 201 COVID-19 patients in Changsha, China, a city outside of Wuhan. All of the patients with confirmed COVID-19 were admitted to the First Hospital of Changsha City, the designated hospital for COVID-19 assigned by the Changsha City Government. The clinical and epidemiological characteristics, data of laboratory, radiological picture, treatment, and outcomes records of 201 COVID-19 patients were collected using electronic medical records. This study population consisted of 201 hospitalized patients with laboratory-confirmed COVID-19 in Changsha by April 28, 2020. The median age of the patients was 45 years (IQR 34-59). About half (50.7%) of the patients were male, and most of the infected patients were staff (96 [47.8%]). Concerning the epidemiologic history, the number of patients linked to Wuhan was 92 (45.8%). The most common symptoms were fever (125 [62.2%]), dry cough (118 [58.7%]), fatigue (65 [32.3%]), and pharyngalgia (31 [15.4%]). One hundred and forty-four (71.6%) enrolled patients showed bilateral pneumonia. Fifty-four (26.9%) patients showed unilateral involvement, and three (1.5%) patients showed no abnormal signs or symptoms. The laboratory findings differed significantly between the Intensive Care Unit (ICU) and non-ICU groups. Compared with non-ICU patients, ICU patients had depressed white blood cell (WBC), neutrocytes, lymphocytes, and prolonged prothrombin time (PT). Moreover, higher plasma levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALA), aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase-MB (CK-MB), creatinine (CREA), and lactate dehydrogenase (LDH) were detected in the ICU group. In this single-center study of 201 COVID-19 patients in Changsha, China, 22.4% of patients were admitted to ICU. Based on our findings, we propose that the risk of cellular immune deficiency, hepatic injury, and kidney injury should be monitored. Previous reports focused on the clinical features of patients from Wuhan, China. With the global epidemic of COVID-19, we should pay more attention to the clinical and epidemiological characteristics of patients outside of Wuhan.
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