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Clinical Characteristics between COVID-19 Patients In and Outside Wuhan: A Multiple-Centered Retrospective Study
31 Pages Posted: 23 Apr 2020
More...Abstract
Background: Novel coronavirus disease COVID-19 has caused great damage to global public health. Wuhan is the first outbreak city in China, with the obviously higher mortality rate than other regions of China. However, comparison of clinical characteristics in different regions is still lacking.
Methods: In this multiple-centered, retrospective, observational study, 208 patients (101 were hospitalized in Wuhan and 107 in Hunan) diagnosed with COVID-19 from December 16, 2019 to February 21, 2020 were enrolled. Demographic, epidemiological, clinical, treatment, laboratory data and pulmonary CT scans of patients in Wuhan and Hunan were collected and analyzed.
Findings: 208 patients were enrolled in this study, of whom 153 were non-severe and 55 were severe. Compared to Hunan, non-severe patients in Wuhan presented with more fever (75·8% vs 39·1%) and fatigue (28·8% vs 13·8%), higher percentage of application of oxygen and drugs therapies, lower leucocyte count [4·48 (3·27-5.77) vs 5·04 (4·05-5·33)] and lymphocyte count [0·99 (0·67-1·36) vs 1·25 (0·99-1·74)], longer duration of viral shedding time after symptoms onset [19 days (16-22) vs 11 days (7-14)] and longer hospital lengths of stay [23 days (18-26) vs 10 days (8-14)]. Of non-severe patients in Wuhan, the CT scans showed more bilateral ground-glass opacity (GGO) but less single GGO, lower absorption rate of lung consolidation and more involved lung lobes than non-severe patients in Hunan. Severe patients in Wuhan less likely presented cough (42·9% vs 95%), more requirement of high-flow nasal cannula oxygen therapy (71·4% vs 30%), lower leucocyte [5·9 (3·73-6·63) vs 6·2 (4·97-9·33)] and lymphocyte count [0·65 (0·46-0·88) vs 0·82 (0·59-1·06)] and higher mortality rate (51·4% vs 0) than severe patients in Hunan.
Interpretation: The clinical characteristics of patients in Wuhan and Hunan showed more serious severity of disease, prolonged hospital length of stay and worse prognosis in Wuhan patients. Furthermore, patients in Hunan imported from Wuhan were with less severity than patients staying in Wuhan, which might be due to the lower density of patients, shorter viral shedding time and lower viral load of patients in Hunan.
Funding Statement: This study was supported by the Emergency Project of Prevention and Control for COVID-19 of Central South University (Grant 16026000 to Jie Meng).
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: This study was approved by the Ethic Committee of COVID-19 designated hospitals (Ethic number: K-20040).
Keywords: COVID-19; SARS-CoV-2; clinical characteristics; viral shedding time; mortality rate
Suggested Citation: Suggested Citation