Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2021; 9(10): 2205-2217
Published online Apr 6, 2021. doi: 10.12998/wjcc.v9.i10.2205
Epidemiological and clinical characteristics of 65 hospitalized patients with COVID-19 in Liaoning, China
Wei Zhang, Yuan Ban, Yun-Hai Wu, Jin-Yang Liu, Xing-Hai Li, Hao Wu, Huan Li, Rui Chen, Xiao-Xu Yu, Rui Zheng
Wei Zhang, Hao Wu, Huan Li, Rui Chen, Xiao-Xu Yu, Rui Zheng, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Yuan Ban, Yun-Hai Wu, Department of Critical Care Medicine, The Sixth People's Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
Jin-Yang Liu, Xing-Hai Li, Department of Infectious Diseases, The Sixth People's Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
Author contributions: Zhang W contributed to study design, data analysis, and manuscript drafting and revision; Ban Y, Wu YH, Liu JY, and Li XH contributed to this work with regard to data collection and manuscript revision; Wu H, Li H, Chen R, and Yu XX contributed to data analysis and manuscript revision; Zheng R had a contribution in conceptual work, study design, and revising of the manuscript; all co-authors have given the final approval of the version to be published.
Supported by 345 Talent Program of Shengjing Hospital; and Scientific Research Projects Related to Prevention and Control of Coronavirus Disease 2019 (COVID-19) of China Medical University, No. 1210120010.
Institutional review board statement: This study was approved by the Medical Ethics Committee from Shengjing Hospital of China Medical University (reference number 2020PS065K).
Informed consent statement: Patients were not required to give informed consent to the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Zheng, MD, PhD, Chief Physician, Deputy Director, Doctor, Professor, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. zhengr@sj-hospital.org
Received: September 22, 2020
Peer-review started: September 22, 2020
First decision: December 13, 2020
Revised: January 15, 2021
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: April 6, 2021
Abstract
BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread rapidly to multiple countries through its infectious agent severe acute respiratory syndrome coronavirus 2. The severity, atypical clinical presentation, and lack of specific anti-viral treatments have posed a challenge for the diagnosis and treatment of COVID-19. Understanding the epidemiological and clinical characteristics of COVID-19 cases in different geographical areas is essential to improve the prognosis of COVID-19 patients and slow the spread of the disease.

AIM

To investigate the epidemiological and clinical characteristics and main therapeutic strategy for confirmed COVID-19 patients hospitalized in Liaoning Province, China.

METHODS

Adult patients (n = 65) with confirmed COVID-19 were enrolled in this retrospective study from January 20 to February 29, 2020 in Liaoning Province, China. Pharyngeal swabs and sputum specimens were collected from the patients for the detection of severe acute respiratory syndrome coronavirus 2 nucleic acid. Patient demographic information and clinical data were collected from the medical records. Based on the severity of COVID-19, the patients were divided into nonsevere and severe groups. All patients were followed until March 20, 2020.

RESULTS

The mean age of 65 COVID-19 patients was 45.5 ± 14.4 years, 56.9% were men, and 24.6% were severe cases. During the 14 d before symptom onset, 25 (38.5%) patients lived or stayed in Wuhan, whereas 8 (12.3%) had no clear history of exposure. Twenty-nine (44.6%) patients had at least one comorbidity; hypertension and diabetes were the most common comorbidities. Compared with nonsevere patients, severe patients had significantly lower lymphocyte counts [median value 1.3 × 109/L (interquartile range 0.9-1.95) vs 0.82 × 109/L (0.44-1.08), P < 0.001], elevated levels of lactate dehydrogenase [450 U/L (386-476) vs 707 U/L (592-980), P < 0.001] and C-reactive protein [6.1 mg/L (1.5-7.2) vs 52 mg/L (12.7-100.8), P < 0.001], and a prolonged median duration of viral shedding [19.5 d (16-21) vs 23.5 d (19.6-30.3), P = 0.001]. The overall median viral shedding time was 19.5 d, and the longest was 53 d. Severe patients were more frequently treated with lopinavir/ritonavir, antibiotics, glucocorticoid therapy, immunoglobulin, thymosin, and oxygen support. All patients were discharged following treatment in quarantine.

CONCLUSION

Our findings may facilitate the identification of severe cases and inform clinical treatment and quarantine decisions regarding COVID-19.

Keywords: Coronavirus disease, COVID-19, Epidemiology, Liaoning, SARS-CoV-2, Viral pneumonia

Core Tip: This study describes the clinical and laboratory characteristics of 65 adult coronavirus disease 2019 (COVID-19) patients who were diagnosed and treated in Liaoning Province. The prevalence of afebrile patients was significantly higher in nonsevere COVID-19 patients than in severe patients, whereas severe COVID-19 patients were more likely to have lymphopenia and elevated levels of lactate dehydrogenase and C-reactive protein. The longer median duration of viral shedding in severe patients should be noted to improve transmission control measures.