Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China - JAMA

Bron: https://jamanetwork.com/journals/jama/fullarticle/2761044

By: D. Wang, B. Hu, C. Hu

Aim
What are the clinical characteristics of hospitalized patients with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China?

Key

• 26% of admitted patients require ICU care
• Median 7 days from onset of symptoms to hospital admission and 10 to ICU
• Common symptoms at onset of illness were fever, dry cough, myalgia, fatigue, dyspnea, and anorexia. However, a significant proportion of patients presented initially with atypical symptoms, such as diarrhea and nausea. 
• Major complications during hospitalization included ARDS, arrhythmia, and shock. 
• Bilateral distribution of patchy shadows and ground glass opacity was a typical hallmark of CT scan. 

Summary

• Clinical characteristics of 138 PCR proven covid19 patients in a Wuhan university hospital were described. 
• Median age: 56 years (range 22-92). 54.3% men. 
• 26.1% of patients admitted to the ICU. 
• Resp. 7, 8, and 10 days from onset of symptoms to hospital admission, ARDS, ICU admission
• 54% of patients without comorbidity. 
• Most common symptoms at onset; fever [98.6%], fatigue [69.6%], dry cough [59.4%], myalgia [34.8%], and dyspnea [31.2%]. Less common symptoms were headache, dizziness, abdominal pain, diarrhea, nausea, and vomiting.
• 41% were presumed to have been infected in the hospital of whom 29% was hospital personnel. Prevention of spread is key! Including a lot of surgical personnel since one patient was admitted with abdominal pain without further symptoms!
• ICU patients were older, more comorbidities, and more often reported: pharyngeal pain, dyspnea, dizziness, abdominal pain, and anorexia.
• ICU patients had higher white blood cell count, higher d-dimer, and higher creatine kinase at presentation.  
• All patients (100%) show bilateral involvement on chest CT.
• At follow-up of 5 to 35 days, 4.3% of patients had died (so probably underestimation)
• ICU complications and treatment:​
• Course of laboratory findings in survivors vs non-survivors: