lancet-header
Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed and are posted here as part of a 12-month trial. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed. For more information see the Comment published in The Lancet, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com

Early and Critical Care in Severe Patients with COVID-19 in Jiangsu Province, China: A Descriptive Study

24 Pages Posted: 3 Mar 2020

See all articles by Mao Huang

Mao Huang

Nanjing Medical University - Department of Pulmonary and Critical Care Medicine

Yi Yang

Southeast University (China) - Department of Critical Care Medicine

Futai Shang

Nanjing Medical University - Department of Critical Care Medicine

Yishan Zheng

Nanjing University of Chinese Medicine (NJUCM) - Department of Critical Medicine

Wenjing Zhao

Xuzhou Medical University - Department of Critical Care Medicine

Liang Luo

Wuxi No. 2 People's Hospital - Department of Critical Care Medicine

Xudong Han

Nantong University - Department of Critical Care Medicine

Aihua Lin

Nanjing Gulou Hospital Group - Department of Critical Care Medicine

Hongsheng Zhao

Nantong University - Department of Critical Care Medicine

Qing Gu

Nanjing University - Department of Critical Care Medicine

Yi Shi

Nanjing Jinlin Hospital - Department of Pulmonary and Critical Care Medicine

Jun Li

Nanjing Medical University - Department of Infectious Diseases

Xingxiang Xu

Northern Jiangsu People's Hospital - Department of Pulmonary and Critical Care Medicine

Kexi Liu

Lianyungang First People's Hospital - Department of Critical Care Medicine

YiJun Deng

Yancheng First People's Hospital - Department of Critical Care Medicine

Quan Cao

Nanjing Medical University - Department of Critical Care Medicine

Weiwei Wang

Nanjing Medical University - Department of Critical Care Medicine

More...

Abstract

Background: Patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which originated in Wuhan, China, and spreading over the country including Jiangsu Province. Our study aimed to study the epidemiological, clinical characteristics and therapies of these severe cases in Jiangsu Province.

Methods: Patients with severe COVID-19 pneumonia who were admitted to 12 first-tier hospitals in Jiangsu Province between Jan 24 and Feb 23, 2020 were retrospective enrolled. All diagnosis were confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR). Clinical characteristics and prognosis of 60 cases with COVID-19 were compared and analysis.

Findings: A total of 631 infected cases with COVID-19 in Jiangsu Province, 60 of which were severe cases. Up until Feb 23, 2020, the mortality rate of these severe patients was 0%. The median age was 57 years (range, 26 to 97), and 58 · 3% were man. The body mass index (BMI) of these patients was higher, with an average of 25 kg/m2. 51 · 7% of cases had at least one comorbidity. Mean acute physiology and chronic health evaluation (APACHE) II score on admission was 14±5. Acute respiratory distress syndrome (ARDS) appeared in 15% of the patients. White blood cell counts decreased in 45 · 0% of patients, lymphopenia in 63 · 3%, thrombocytopenia in 13 · 3%, and procalcitonin levels in 88 · 3% of the patients were less than 0 · 5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and glucocorticoids therapy between the improvement and deterioration subgroups ( P >0 · 05). Logistic regression analysis showed higher levels of troponin T (odds ratio [OR]: 1 · 04; 95% confidence interval [CI]: 1 · 00-1 · 08; P =0 · 04), antiviral therapy with interferon (OR: 6 · 33; 95% CI: 1 · 18-33 䟞 P =0 · 03), and the application of non-invasive mechanical ventilation (OR: 1 · 99; 95%CI: 1 · 17-3 · 41; P =0 · 01) correlated with disease progression, wherea higher lymphocyte count (OR: 0 · 11; 95% CI: 0 · 02-0 · 57; P =0 · 01) and prone ventilation were associated with improvement (OR: 0 · 11; 95% CI: 0 · 01-0 · 98; P =0 · 04).

Interpretation: The COVID-19 had a low mortality rate in Jiangsu Province, China. In patients with severe COVID-19 pneumonia, early comprehensive care and oxygen support therapy are the key to success treatment. With non-invasive ventilation or high flow nasal cannula combined prone ventilation might additionally improve hypoxia and protect organ function.

Funding Statement: The authors stated that this research was not funded.

Declaration of Interests: The authors declare no financial conflicts of interest.

Ethics Approval Statement: The research was approved by independent Ethics Committee of the First Affiliated Hospital of Nanjing Medical University. The requirement for written informed consent was waived by the ethics committee.

Keywords: COVID-19; Severe cases; Clinical data

Suggested Citation

Huang, Mao and Yang, Yi and Shang, Futai and Zheng, Yishan and Zhao, Wenjing and Luo, Liang and Han, Xudong and Lin, Aihua and Zhao, Hongsheng and Gu, Qing and Shi, Yi and Li, Jun and Xu, Xingxiang and Liu, Kexi and Deng, YiJun and Cao, Quan and Wang, Weiwei, Early and Critical Care in Severe Patients with COVID-19 in Jiangsu Province, China: A Descriptive Study (2/26/2020). Available at SSRN: https://ssrn.com/abstract=3546056 or http://dx.doi.org/10.2139/ssrn.3546056

Mao Huang

Nanjing Medical University - Department of Pulmonary and Critical Care Medicine

Nanjing, 210029
China

Yi Yang

Southeast University (China) - Department of Critical Care Medicine

Sipailou 2#
Nanjing, Jiangsu Province 210096
China

Futai Shang

Nanjing Medical University - Department of Critical Care Medicine

Huaian, 223300
China

Yishan Zheng

Nanjing University of Chinese Medicine (NJUCM) - Department of Critical Medicine

China

Wenjing Zhao

Xuzhou Medical University - Department of Critical Care Medicine

Xuzhou, 221006
China

Liang Luo

Wuxi No. 2 People's Hospital - Department of Critical Care Medicine

Wuxi, 214002
China

Xudong Han

Nantong University - Department of Critical Care Medicine

Nantong, 226006
China

Aihua Lin

Nanjing Gulou Hospital Group - Department of Critical Care Medicine

Suqian, 223800
China

Hongsheng Zhao

Nantong University - Department of Critical Care Medicine

Nantong, 226001
China

Qing Gu

Nanjing University - Department of Critical Care Medicine

Nanjing, 210008
China

Yi Shi

Nanjing Jinlin Hospital - Department of Pulmonary and Critical Care Medicine

Nanjing, 210002
China

Jun Li

Nanjing Medical University - Department of Infectious Diseases

Nanjing, 210029
China

Xingxiang Xu

Northern Jiangsu People's Hospital - Department of Pulmonary and Critical Care Medicine

Yangzhou, 225001
China

Kexi Liu

Lianyungang First People's Hospital - Department of Critical Care Medicine

Lianyungang, 222002
China

YiJun Deng

Yancheng First People's Hospital - Department of Critical Care Medicine

Yancheng, 224006
China

Quan Cao (Contact Author)

Nanjing Medical University - Department of Critical Care Medicine ( email )

Nanjing, 210029
China

Weiwei Wang

Nanjing Medical University - Department of Critical Care Medicine ( email )

Nanjing, 210029
China

Click here to go to TheLancet.com

Paper statistics

Abstract Views
724
Downloads
149