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Cited by 20,148COVID-19 Clinical Research StudiesSARS-CoV-2 and COVID-19 ResearchLong-Term Effects of COVID-19

Clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-Infected pneumonia in Wuhan, China

Open access
Wang, Dawei, Hu, Bo, Hu, Chang, Zhu, Fangfang, Liu, Xing, Zhang, Jing, Wang, Binbin, Xiang, Hui +6 more·2020·JAMA
DOI 10.1001/jama.2020.1585PMC PMC7042881
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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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  1. Power, M., Doherty, B., Pybus, K. & Pickett, K. (2020). How COVID-19 has exposed inequalities in the UK food system: The case of UK food and poverty. Emerald Open Research, 2, 11. https:// doi.org/10.35241/emeraldopenres.13539. · DOI
  2. Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X. & Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 323(11), 1061. https://doi.org/10.1001/jama.2020.1585

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Authors
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X., & Peng, Z.
Affiliations
Zhongnan Hospital of Wuhan University (CN)
Corresponding author
  • Wang, Xinghuan
  • Peng, Zhiyong
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2020-03-17
Volume
323
Issue
11
Pages
1061
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2020.1585
PMC
PMC7042881
OpenAlex
W3005079553
Cited by
20,148
References
22
Citations by year
2026: 168 · 2025: 422 · 2024: 942 · 2023: 1691 · 2022: 3039 · 2021: 5484 · 2020: 8388 · 2019: 8 · 2013: 2 · 2012: 2
FWCI
609.91
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
Keywords
SARS-CoV-2, COVID-19 pandemic, pneumonia, hospitalized patients, clinical features, healthcare workers, lymphopenia, prothrombin time, lactate dehydrogenase, chest CT findings, oseltamivir, remdesivir, hydroxychloroquine, corticosteroids, mechanical ventilation, critically ill patients
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, Aged, 80 and over, China, Female, Hospitalization, Humans, Lung, Male, Middle Aged, Pneumonia, Viral, Retrospective Studies, Tomography, X-Ray Computed, Critical Illness, Coronavirus Infections, Disease Transmission, Infectious, Young Adult, Vital Signs, Pandemics, Real-Time Polymerase Chain Reaction

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