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Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China
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Abstract
Background: In December 2019, coronavirus disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods: Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan and Xishui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic, and clinical data were collected. The clinical course of survivors and non-survivors were compared. Risk factors for death were analyzed. Results: A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever, cough, dyspnea, lymphopenia, and radiological multi-lobar pulmonary infiltrates. In severe cases, thrombocytopenia, acute kidney injury, acute myocardial injury, and adult respiratory distress syndrome were observed. During week 2, in mild cases, fever, cough, and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia persisted. In severe cases, leukocytosis, neutrophilia, and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia. However, severe cases showed persistent lymphopenia, severe acute respiratory dyspnea syndrome, refractory shock, anuric acute kidney injury, coagulopathy, thrombocytopenia, and death. Older age and male sex were independent risk factors for poor outcome of the illness. Conclusions: A period of 7–13 days after illness onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors for death of COVID-19.
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“A review of 107 patients with COVID-19 showed that 7 to 13 days after illness onset is a critical stage in this disease (67).”
From Lung epithelial and endothelial damage, loss of tissue repair, inhibition of fibrinolysis, and cellular senescence in fatal COVID-19 (2021) · cites this paper as [67]
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Metadata
- Authors
- Wang, D., Yin, Y., Hu, C., Liu, X., Zhang, X., Zhou, S., Jian, M., Xu, H., Prowle, J., Hu, B., Li, Y., & Peng, Z.
- Affiliations
- Zhongnan Hospital of Wuhan University (CN)
- Barts Health NHS Trust (GB)
- Corresponding author
- Li, Yirong
- Peng, Zhiyong
- ORCID
- Venue
- Critical Care
- Published
- 2020-04-30
- Volume
- 24
- Issue
- 1
- Pages
- 188-188
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC7192564
- OpenAlex
- W3023796702
- Cited by
- 397
- References
- 24
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 16 · 2023: 21 · 2022: 59 · 2021: 134 · 2020: 161
- FWCI
- 12.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Critical Care (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
- Funders
- National Natural Science Foundation of China (81701941, 81772046, 81971816)
- National Major Science and Technology Projects of China (2020ZX09201007)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- COVID-19 pandemic, SARS-CoV-2, clinical course, prognosis, mortality risk factors, lymphopenia, acute respiratory distress syndrome, acute kidney injury, thrombocytopenia, multiple organ failure, old age, male sex, Wuhan
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Age Factors, Aged, Aged, 80 and over, China, Cough, Female, Fever, Heart, Humans, Lymphopenia, Male, Middle Aged, Patient Discharge, Pneumonia, Viral, Prognosis, Respiratory Distress Syndrome, Retrospective Studies, Risk Factors, Sex Factors, Thrombocytopenia, Coronavirus Infections, Young Adult, Acute Kidney Injury, Pandemics
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