Clinical progression of patients with COVID-19 in Shanghai, China - 14/04/20
Highlights |
• | Most of the COVID-19 cases are mild. |
• | The estimated median duration of fever was 10 days. |
• | Radiological improvement was observed on 14 days after onset of symptoms. |
• | The median duration to negative reverse-transcriptase PCR tests of upper respiratory tract samples was 11 days. |
Summary |
Background |
Studies on the 2019 novel coronavirus disease (COVID-19) have generally been limited to the description of the epidemiology and initial clinical characteristics. We investigated the temporal progression in patients with COVID-19.
Methods |
In this retrospective, single-center study, we included confirmed cases of COVID-19 from Jan 20 to Feb 6, 2020 in Shanghai. Final date of follow-up was February 25, 2020.
Results |
Of the 249 patients enrolled, the median age was 51 years old, and 126 (50.6%) were male. The duration from onset of symptoms to hospitalization was 4(2–7) days in symptomatic patients. Fever was occurred in 235(94.3%) patients. A total of 215 (86.3%) patients had been discharged after 16(12–20) days hospitalization. The estimated median duration of fever in all the patients with fever was 10 days (95 confidential intervals [CIs]: 8–11 days) after onset of symptoms. Patients who were transferred to intensive care units (ICU) had significantly longer duration of fever as compared to those not in ICU (31 days v.s. 9 days after onset of symptoms, respectively, P <0.0001). Radiological aggravation of initial image was observed in 163 (65.7%) patients on day 7 after onset of symptoms. 154(94.5%) of these patients showed radiological improvement on day 14. The median duration to negative reverse-transcriptase PCR tests of upper respiratory tract samples was 11 days (95 CIs: 10–12 days). Viral clearance was more likely to be delayed in patients in ICU than those not in ICU (P <0.0001). In multivariate logistical analysis, age (Odds ratio [OR] = 1.06) and CD4 T cell count (OR = 0.55 per 100 cells/ul increase) were independently associated with ICU admission.
Conclusions |
The majority of COVID-19 cases are mild. The clinical progression pattern suggests that early control of viral replication and application of host-directed therapy in later stage is essential to improve the prognosis of CVOID-19.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, SARS-CoV-2, Clinical progression, Viral clearance, Clinical characteristics
Plan
Vol 80 - N° 5
P. e1-e6 - mai 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.