Clinical features of 19 severe cases of COVID-19 in Beijing
10.3760/cma.j.cn112866-20200224-00030
- VernacularTitle:北京地区19例重症和危重症COVID-19患者临床分析
- Author:
Aihua JIN
1
;
Lin JIA
;
Benyong YAN
;
Wei HUA
;
Dandan FENG
;
Yulin ZHANG
;
Caiping GUO
;
Lianchun LIANG
Author Information
1. 首都医科大学附属北京佑安医院感染中心C8病区，北京 100069
- Keywords:
2019-nCoV;
Clinical features;
COVID-19;
Critically ill diseases
- From:
Chinese Journal of Experimental and Clinical Virology
2020;34(3):225-230
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the clinical characteristics of patients with Corona virus Disease 2019 (COVID-19) so as to further provide practical references for clinical practice through collecting and analyzing the clinical data of COVID-19 patients admitted to Beijing Yuoan Hospital.Methods:The clinical data were summarized and analyzed for COVID-19 classified as severe patients and critically ill patients between January 28, 2020 and February 12, 2020 in Beijing Youan Hospital, including their age, gender, course of disease, epidemiological history, previous history, clinical symptoms, laboratory tests, CT findings of lungs, treatment and clinical outcomes. Statistical processing was performed using SPSS software (version 22.0).Results:Nineteen patients were included in this study and divided into two groups by investigators, i. e. ten of the patients had severe type and 9 had the critically ill type of the disease. The average age of the patients was 75 years (range from 58 to 94 years), including 10 males and 9 females. Their course of diseases varied from 1 day to 14 days with a median of 5 days. Among these patients, 4 patients resided in Wuhan, 13 patients had been in close contact with confirmed patients (including family gatherings, during meals, living in the same room, etc.), and 2 patients had no relevant epidemiological history. Fourteen patients suffered from underlying chronic diseases (including 11 cases with hypertension, 4 cases with coronary heart disease, 4 cases with cardiac insufficiency, 3 cases of chronic obstructive pulmonary disease, 2 cases of previous anterior myocardial infarction, 3 cases of arrhythmia, 1 case of heart valve disorders, 2 cases of diabetes mellitus, 2 cases of chronic renal disease, etc.), and 4 patients had 3 or more underlying diseases at the same time. The first symptoms at onset of illness were fever in 18 cases, cough in 13 cases, and dyspnea in 8 cases. Seventeen patients had absolute lymphocyte count (ALC) lower than the normal range. Eleven patients experienced different degrees of hepatic injury, 10 patients had renal injury, 7 patients had abnormal myocardial enzymes to a varying degree. C-reactive protein was increased in 18 patients.12 patients received hormone therapy, 4 patients were treated with gamma globulin, 3 patients used non-invasive ventilator mechanical ventilation, and 7 patients used an invasive ventilator to assist ventilation. Moreover, 1 patient received continuous renal replacement therapy (CRRT), and 1 patient was treated with extracorporeal membrane oxygenation (ECMO). As of February 17, 2020, 10 patients had recovered or been discharged upon treatment, 4 patients were still in the intensive care unit (ICU), and 5 patients had died.Conclusions:The elderly and individuals who had underlying diseases were considered as independent predictors for developing severe and critical disease, and were at higher risk of increased mortality. The decrease of ALC and the increase of C-reactive protein levels in the patients, and the abnormality of liver function, renal function and myocardial enzyme spectrum to different degrees suggest the correlation with severe cases. Steroids and ventilator are effective in the treatment of severe cases.
