Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu

J Clin Virol. 2020 Jun:127:104366. doi: 10.1016/j.jcv.2020.104366. Epub 2020 Apr 10.

Abstract

Background: In December 2019, Wuhan, China, experienced an outbreak of coronavirus (COVID-19). The number of cases has increased rapidly, but information on the clinical characteristics remains limited.

Objectives: This paper describes the epidemiological and clinical characteristics of COVID-19. Early detection and identification of critically ill patients is necessary to facilitate scientific classification and treatment.

Study design: This study included a retrospective, single-center case series of 99 consecutively hospitalized patients with confirmed COVID-19 at Chengdu Public Health Clinical Medical Center in Chengdu, China, from January 16 to February 20, 2020. The final date of follow-up was February 23, 2020. We collected and analyzed epidemiological, demographic, clinical, laboratory, radiological, and treatment data. We compared outcomes of critically ill patients and noncritically ill patients.

Results: Of the 99 hospitalized patients with COVID-19, the median age was 49 years (minimum, 3 months; maximum, 87 years) and 51 (52 %) were men; 42 (42 %) had traveled to or lived in Wuhan and 48 (49 %) had come into close contact with patients with new coronavirus pneumonia; 41 (41 %) patients had underlying disease. Common symptoms included fever (85 [86 %]), dry cough (84 [85 %]), and fatigue (72 [73 %]). We analyzed the clinical characteristics of patients. We expressed the measurement data as mean ± standard deviation. We collected data for age (49.39 ± 18.45 years), number of hospital days (12.32 ± 6.70 days), and laboratory indicators. We compared critically ill and noncritically ill patients: p-values for age, C-reactive protein, high-sensitivity troponin T, prothrombin time, fibrin degradation products, D-Dimer, and CD4+ count were p < 0.001; and p-values for hospital days, white blood cell, neutrophil, lymphocyte, creatine kinase isoenzyme, myoglobin, N-terminal brain natriuretic peptide, and CD8+ count were p < 0.05.

Conclusions: We collected data from a single-center case series of 32 hospitalized patients who were critically ill with confirmed COVID-19 in Chengdu, China, and compared data with 67 noncritically ill patients. Elderly patients had chronic underlying diseases, notably cardiovascular disease. Higher C-reactive protein levels, higher levels of myocardial damage, and higher brain natriuretic peptide levels; lower white blood cells, neutrophils, and lymphocytes; and lower CD4 and CD8 counts could be used for early detection and identification of critically ill patients, and dynamic Data observation was more important than at a single moment.

Keywords: COVID-19; Chengdu; Clinical features; Critical illness; Epidemiological characteristics.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • CD4 Lymphocyte Count
  • COVID-19
  • Child
  • Child, Preschool
  • China / epidemiology
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / physiopathology*
  • Cough / virology
  • Critical Illness
  • Fatigue / virology
  • Female
  • Fever / virology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / physiopathology*
  • Retrospective Studies
  • SARS-CoV-2
  • Treatment Outcome
  • Young Adult