Clinical Features and Treatment of 2019-nCov Pneumonia Patients in Wuhan: Report of A Couple Cases

Abstract

nCoV) has caused more than one hundred cases in Wuhan (WMHC 2020). During a retrospective study of recent pneumonia patients in our department, we found two patients who are likely being infected with the 2019-nCoV. During the hospitalization, those two patients were appropriately treated, and both were discharged within two weeks. Thus, we are reporting the clinical features and treatment regiment, and hope the information and experience can be shared.The two patients were a couple. The male was 38 years old, and was admitted to the hospital due to fever for one week and dyspnea for one day on Dec. 27, 2019. On admission, he had slight cough of a little green viscous sputum. He had been treated with normal anti-infective therapy in another hospital for 3 days, but did not respond it. After then, he visited our department. The radiography of the chest at the OPD suggested the right lung infection.He was previously healthy, and had a history of allergy to heartleaf houttuynia herb (a traditional Chinese medicine). Physical examination (PE) on admission: T: 37.4°C; P: 95 bpm; R: 20 bpm; and BP: 129/73 mmHg. The breath sounds of both lungs were coarse, and no dry or moist rales were auscultated. The heart and abdomen were unremarkable. Routine urine test: urine glucose: 1?; urine specific gravity: 1.03; protein: 1?; and the others were within the normal ranges. Routine stool test: occult blood (chemical method): weakly positive. The creatine kinase was within the normal range; lactate dehydrogenase: 279 U/L:; and procalcitonin was within the normal range.To figure out the potential pathogen of his infection, a panel of extra laboratory tests was performed, and the results are shown in Table 1. Through those tests, all clinically frequent pathogens are excluded.During the hospitalization, the CT scans of lungs and the dynamics of immune responses were closely monitored. Summary reports of serial CT scans and serial blood tests of the male patient are shown in Fig. 1 and Table 2.After admission, according to our clinical experience, the patient was given methylprednisolone 40 mg iv gtt for once, and then the fever subsided. The patient was given human gamma globulin 10 g iv gtt qd for five successive days, and then the dose was changed to 5 g. Considering the cause was unknown, we also used drugs to treat atypical pathogens, including moxifloxacin for mycoplasma and chlamydia, and oseltamivir and abidol hydrochloride for influenza A virus; meanwhile, the patient was given Chinese patent medicine Tanreqing iv gtt for adjunctive therapy. On Jan 10, 2020, the male patient was re-examined for all inflammatory indices and all showed normal, and he was discharged from hospital on the same day.The female patient was 38 years old and was admitted due to fever, cough, and vomiting for one day on Dec 30, 2019. On admission, she had no dyspnea, no chest distress, no expectoration, no pharyngalgia, no nasal discharge, nor nasal obstruction. She was previously healthy, and had no history of allergy to food or drug. PE on admission...

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