A recent report provides a comprehensive look at the symptoms, clinical findings, and treatment of the patients infected with 2019 novel coronavirus in Wuhan, China.
The coronavirus outbreak that originated in Wuhan, China has now spread to 24 countries across the world. What started as several cases of pneumonia with an unknown cause in December 2019 has now increased to over 25,000 cases of infection (as of 5th February 2020) with the 2019 novel-Coronavirus (2019-nCoV) and the latest death toll is 491 fatalities.
An analysis of the epidemiological pattern and clinical findings from the first 99 patients admitted to the Jinyintan Hospital in Wuhan, China, was published in the journal The Lancet on January 29th 2020. The patients in this study included the first reported cases of patients infected with 2019-nCoV. The authors included clinical records, imaging data, laboratory results, and epidemiological data from patients admitted between January 1 and January 20, 2020 in this report.
Demographics of the patients
The demographic profiles of patients infected with 2019-nCoV:
- Most of the patients are middle-aged with an average of 55.5 years.
- Majority of the patients are male; 67 of the 99 patients are men.
- Over 50% of the patients suffered from chronic diseases including cardiovascular and cerebrovascular diseases (40 patients) and diabetes (12 patients).
Close to half of the patients initially affected had a history of direct exposure at the Huanan seafood market where the infection is thought to have originated. Of the 49 patients with direct exposure, 46 patients worked as managers or salespeople, thus exposing them to the virus over a longer period of time as compared to the shorter exposure of the two patients who were shopping at the market.
Signs & symptoms of coronavirus infection
The most common symptoms described by the patients were fever (82 patients) and cough (81 patients). A third of the patients (31) experienced shortness of breath. Other symptoms experienced by around 5 to 11% of the patients included muscle ache, confusion, headache, and sore throat.
Clinical findings in patients infected with 2019 novel coronavirus
- All the patients had pneumonia. The majority of the patients (75%) were infected in both lungs.
- Many patients (17%) presented with Acute Respiratory Distress Syndrome.
- About 8% of patients suffered from acute respiratory injury.
- About 3% of the patients suffered from kidney damage; 4% of the patients suffered from septic shock, and one patient suffered from ventilator-associated pneumonia.
- Five critically ill patients also showed coinfections with bacteria (1 patient) and fungi (4 patients).
Treatment and prognosis
All of the patients were treated in quarantine. The majority of the patients were treated with antivirals, for three to fourteen days. About 25 to 45% of the patients were treated with antibiotics for three to seventeen days. Most patients also received oxygen therapy. While most of the patients responded well to the treatment, with over thirty patients discharged by January 25th 2020, over half of the patients are still in the hospital. Seventeen patients developed acute respiratory distress syndrome and 11 of these patients died.
This study was the largest of its kind studying patients infected with 2019-nCoV, and provides critical information regarding the characteristics of this virus infection. As the numbers of infected patients keep increasing, additional information from larger studies is needed to help understand this infection and contain the spread.
Written by Bhavana Achary, Ph.D
Link to original study – https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30211-7/fulltext
Latest data on number of cases across the world (5th February 2020) – https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200205-sitrep-16-ncov.pdf?sfvrsn=23af287f_4
Image by Gerd Altmann from Pixabay