Clinical Characteristics of Pneumonia Patients of Long Courses Infected with SARS-CoV-2

Abstract

Background: Since December, 2019, Wuhan, China, has experienced an outbreak of 2019 novel coronavirus pneumonia (COVID-19). Epidemiological and clinical characteristics of patients with COVID-19 have been reported. A few studies reported clinical course of illness of median 22 days, including viral shedding of median 20 days, but there are several cases with a longer time of viral shedding.

Methods: In this retrospective, single-centre cohort study, we included four cases with a longer course of illness of more than 40 days with laboratory-confirmed COVID-19 from Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or still in hospital by March 15, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records. We describe the epidemiological and clinical characteristics and the course of disease/viral shedding.

Findings: Of the four patients, one was discharged and the other three were still in-hospital. Two patients had comorbidity, one with hypertension and one with diabetes. We found smoking is not an independent risk factor. And D-Dimer maybe relates to severity of illness but not course of illness. Decreased lymphocyte count had a slow recovery process in three patients. elevated eosinophils count in all patients suggest maybe elevated eosinophils count was a reason of long course. Nucleic acid detection suggests maybe more sampling sites represent more virus replication sites and longer course illness.

Interpretation: In this study we find some non-critical severe relatively young patients with long illness courses of more than 40 days whose character is different from former studies described. Of course, it needs much more cases to further study. It’s hoped to provide strategy of isolation of infected patients and optimal antiviral interventions in the future.

Funding Statement: 1, Zhejiang University special scientific research fund for COVID-19 prevention and control(2020XGZX065); 2, Shanghai Science and Technology Commission Fund for Medical Device(18441905200)

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: The study was approved by Ethics Commission of Xinhua Hospital affiliated to Shanghai Jiaotong University. Written informed consent was waived by the Ethics Commission of the designated hospital for emerging infectious diseases.