Comparative Analysis of 95 Patients with Different Severity in the Early Outbreak of COVID-19 in Wuhan, China

Abstract

Objective. To explore the clinical characteristics of patients with different severity in the early outbreak of COVID-19, hoping to provide reference for clinical diagnosis and treatment. Methods. We retrospectively analyzed the clinical data of 95 COVID-19 patients in Wuhan Red Cross Hospital of China from January 17 to February 13, 2020. All patients were investigated with epidemiological questionnaires. Outcomes were followed up until April 1, 2020. Results. There were 53 males and 42 females, aged 22–84 years (mean 57.3 years). Clinical classification included 54 cases of common type, 27 cases of severe type, and 14 cases of critical type. Six patients had been exposed to the local Huanan seafood market. There were 38 clusters of COVID-19, including 27 family clusters and 11 work unit clusters. Common symptoms included fever (86 (90.5%) of 95), cough (73 (76.8%)), and fatigue (50 (52.6%)). Laboratory findings showed that the most common abnormalities were lymphopenia (75 (78.9%)), elevated D-dimer (60 (63.2%)), and elevated C-reactive protein (56 (58.9%)) on admission. All patients had abnormal chest computed tomography, showing patchy shadows or ground-glass opacities. Severe and critical cases were older, more likely to have shortness of breath, more likely to have underlying comorbidities, and more likely to have abnormal laboratory findings than common cases. The prognosis of patients with different degrees of severity was significantly different. All common and severe patients (100%) were cured and discharged from the hospital, while 10 (71.4%) of 14 critical patients died. Conclusions. COVID-19 has fast transmission speed and high pathogenicity. We must assess the severity of the disease and take corresponding treatment measures as early as possible.

Comorbidities increase the risk of severity and mortality in COVID-19 patients: a systematic review and meta-analysis

“…On the other hand, two meta-analyses found no association between diabetes and severe COVID-19 (Jain & Yuan, 2020;Yang et al, 2020a). Regarding the risk of mortality, similar results were observed in the metaanalyses conducted by and Tian et al (2020), in which diabetic patients were associated with a 3-and 2-fold higher risk of mortality from COVID-19, respectively (Tian et al, 2020b;Wu et al, 2020b). In addition, a meta-analysis carried out by Zheng et al (2020) revealed that diabetes was associated with a 3.68-fold higher risk of developing the critical form of COVID-19 or death from the disease (Zheng et al, 2020c).…”

“…Additionally, the meta-analysis conducted by Tian et al (2020) revealed that patients with chronic kidney disease had a 9.40fold higher risk of death from COVID-19 (Tian et al, 2020b). In contrast, a previous meta-analysis found no association between chronic kidney disease and severe COVID-19, but the small number of studies (4 studies) and patients (n = 15) included may have influenced this analysis (Wang et al, 2020d).…”

“…The data for all participants included in the meta-analysis (344,290 COVID-19 patients) were divided into subgroups, according to patient characteristics. The first subgroup included studies that analysed non-severe and severe cases of COVID-19 (2,501 severe and 6,567 non-severe patients) (Charlotte et al, 2020;Chen et al, 2020a;Dang et al, 2020;de la Rica et al, 2020;Fang et al, 2020;Feng et al, 2020;Guan et al, 2020;He et al, 2020a;He et al, 2020b;Huang et al, 2020;Jiang et al, 2020;Jin et al, 2020;Lee & Kim, 2020;Li et al, 2020c;Liao et al, 2020;Liu et al, 2020a;Liu et al, 2020b;Lv et al, 2020;Shi et al, 2020a;Shu et al, 2020;Wang et al, 2020a;Wang et al, 2020b;Wang et al, 2020c;Wu et al, 2020a;Yang et al, 2020b;Yao et al, 2020;Zhang et al, 2020a;Zhang et al, 2020b;Zhang et al, 2020c;Zheng et al, 2020a;Zhu et al, 2020).…”

“…Six recent meta-analyses have shown that COVID-19 patients with cardiovascular disease have approximately a 3-to 4-fold increased risk from developing severe COVID-19 (Aggarwal et al, 2020;Jain & Yuan, 2020;Liu et al, 2020c;Wang et al, 2020d;Wang et al, 2020e;Yang et al, 2020a). At the same time, the meta-analyses carried out by Tian et al (2020) and showed that patients with this comorbidity had a risk of death 3.80 and 4.85-fold higher in SARS-CoV-2 infection, respectively (Li et al, 2020e;Tian et al, 2020b). Thus, patients with pre-existing cardiovascular diseases infected with SARS-CoV-2 should be monitored more carefully by healthcare professionals, especially cardiologists, to obtain better clinical management.…”

“…The meta-analysis conducted by revealed that cerebrovascular disease was associated with a 3.89-fold higher risk of developing severe COVID-19 (Wang et al, 2020d). In relation to the risk of death, Tian et al (2020) and Pranata et al (2020) showed that COVID-19 patients with cerebrovascular disease had an increased risk of death (Pranata et al, 2020;Tian et al, 2020b). The pathophysiological mechanism that explains the poor clinical evolution of COVID-19 in patients with cerebrovascular disease…”