Epidemiological, Clinical, Radiological Characteristics and Outcomes of Medical Staff with COVID-19 in Wuhan, China: A Single-Centered, Retrospective Case Series Analysis

Abstract

Backgrounds: Since December 2019, a novel coronavirus epidemic has emerged in Wuhan city, China and then rapidly spread to other areas. As of 20 Feb 2020, a total of 2,055 medical staff confirmed with coronavirus disease 2019 (COVID-19) caused by SARS-Cov-2 in China had been reported. We sought to explore the epidemiological, clinical characteristics and prognosis of novel coronavirus-infected medical staff.

Methods: In this retrospective study, 64 confirmed cases of novel coronavirus-infected medical staff admitted to Union Hospital, Wuhan between 16 Jan, 2020 to 15 Feb, 2020 were included. Two groups concerned were extracted from the subjects based on duration of symptoms: group 1 (≤10 days) and group 2 (>10 days). Epidemiological and clinical data were analyzed and compared across groups. The Kaplan-Meier plot was used to inspect the change in hospital discharge rate. The Cox regression model was utilized to identify factors associated with hospital discharge.

Findings: The median age of medical staff included was 35 years old. 64% were female and 67% were nurses. None had an exposure to Huanan seafood wholesale market or wildlife. A small proportion of the cohort had contact with specimens (5%) as well as patients in fever clinics (8%) and isolation wards (5%). Fever (67%) was the most common symptom, followed by cough (47%) and fatigue (34%). The median time interval between symptoms onset and admission was 8.5 days. On admission, 80% of medical staff showed abnormal IL-6 levels and 34% had lymphocytopenia. Chest CT mainly manifested as bilateral (61%), septal/subpleural (80%) and ground­glass (52%) opacities. During the study period, no patients was transferred to intensive care unit or died, and 34 (53%) had been discharged. Higher body mass index (BMI) (≥ 24 kg/m 2 ) (HR 0.14; 95% CI 0.03-0.73), fever (HR 0.24; 95% CI 0.09-0.60) and higher levels of IL-6 on admission (HR 0.31; 95% CI 0.11-0.87) were unfavorable factors for discharge.

Interpretation: In this study, medical staff infected with COVID-19 have relatively milder symptoms and favorable clinical course, which may be partly due to their medical expertise, younger age and less underlying diseases. The potential risk factors of larger BMI, presence of fever symptoms and IL-6 levels greater than >2.9 pg/ml could help to identify novel coronavirus-infected medical staff with poor prognosis at an early stage. Further studies should be devoted to identifying the exact patterns of SARS-CoV-2 infection among medical staff.

Funding Statement: This study was funded by the National Natural Science Foundation of China (number 81873919) and COVID-19 Rapid Response Call of Huazhong University of Science and Technology (No.2020kfyXGYJ021).

Declaration of Interests: All authors declare no competing interests.

Ethics Approval Statement: This retrospective study was approved by the Ethics of Committees of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Written informed consent was waived due to the rapid emergence of this infectious disease.

Keywords: COVID-19; medical staff; infectious disease; retrospective study; Outcomes