Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

Abstract

Background: In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia.

Methods: In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020.

Findings: Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure.

Interpretation: The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection.

Funding: National Key R&D Program of China.

Figure

Chest x-rays and chest CTs of three patients Case 1: chest x-ray was obtained on Jan 1 (1A). The brightness of both lungs was diffusely decreased, showing a large area of patchy shadow with uneven density. Tracheal intubation was seen in the trachea and the heart shadow outline was not clear. The catheter shadow was seen from the right axilla to the mediastinum. Bilateral diaphragmatic surface and costal diaphragmatic angle were not clear, and chest x-ray on Jan 2 showed worse status (1B). Case 2: chest x-ray obtained on Jan 6 (2A). The brightness of both lungs was decreased and multiple patchy shadows were observed; edges were blurred, and large ground-glass opacity and condensation shadows were mainly on the lower right lobe. Tracheal intubation could be seen in the trachea. Heart shadow roughly presents in the normal range. On the left side, the diaphragmatic surface is not clearly displayed. The right side of the diaphragmatic surface was light and smooth and rib phrenic angle was less sharp. Chest x-ray on Jan 10 showed worse status (2B). Case 3: chest CT obtained on Jan 1 (3A) showed mass shadows of high density in both lungs. Bright bronchogram is seen in the lung tissue area of the lesion, which is also called bronchoinflation sign. Chest CT on Jan 15 showed improved status (3B).