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

The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.

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, Cheng, Zhenshun, Xiong, Yong, Zhao, Yan, Li, Yirong, Wang, Xinghuan, Peng, Zhiyong·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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Show all 22 references

Research works printed but not linked: 6

  1. Paules, Coronavirus infections—more than just the common cold, JAMA
  2. Zhu, A novel coronavirus from patients with pneumonia in China, 2019, N Engl J Med
  3. Chen, Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet
  4. Huang, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
  5. Phan, Importation and human-to-human transmission of a novel coronavirus in Vietnam, N Engl J Med
  6. Ranieri, 2012, Acute respiratory distress syndrome: the Berlin definition., JAMA, 307, 2526

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Metadata

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
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 › Clinical 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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