Epidemiological and clinical features of 291 cases with coronavirus disease 2019 in areas adjacent to Hubei, China: a double-center observational study

Abstract

Lei, MD have contributed equally to this work.Word count: 3166 All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. AbstractBackground: The clinical outcomes of COVID-19 patients in Hubei and other areas are different. We aim to investigate the epidemiological and clinical characteristics of patient with COVID-19 in Hunan which is adjacent to Hubei. Methods:In this double-center, observational study, we recruited all consecutive patients with laboratory confirmed COVID-19 from January 23 to February 14, 2020 in two designated hospitals in Hunan province, China. Epidemiological and clinical data from patients' electronic medical records were collected and compared between mild, moderate and severe/critical group in detail. Clinical outcomes were followed up to February 20, 2020. Findings: 291 patients with COVID-19 were categorized into mild group (10.0%), moderate group (72.8%) and severe/critical group (17.2%). The median age of all patients was 46 years (49.8% were male). 86.6% patients had an indirect exposure history. The proportion of patients that had been to Wuhan in severe/critical group (48.0% vs 17.2%, p=0.006) and moderate group (43.4% vs 17.2%, p=0.007) were higher than mild group. Fever (68.7%), cough (60.5%), and fatigue (31.6%) were common symptoms especially for severe and critical patients. Typical lung imaging finding were bilateral and unilateral ground glass opacity or consolidation. Leukopenia, lymphopenia and eosinopenia occurred in 36.1%, 22.7% and 50.2% patients respectively. Increased fibrinogen was detected in 45 of 58 (77.6%) patients with available results. 29 of 44 (65.9%) or 22 of 40 (55.0%) patients were positive in Mycoplasma pneumonia or Chlamydia pneumonia antibody test respectively.Compared with mild or moderate group, severe/critical group had a relative higher level of neutrophil, All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

Comorbid Chronic Diseases and Acute Organ Injuries Are Strongly Correlated with Disease Severity and Mortality among COVID-19 Patients: A Systemic Review and Meta-Analysis

“…Second, we found that the majority of COVID-19 patients with CLD did not require admittance to the ICU, suggesting a less severe disease course in this subset of patients. Consistent with this finding, Chen et al reported that 13 out of 15 patients (86.7%) with both COVID-19 and CLD did not have severe disease [3]. Third, we found that many clinical reports regarding COVID-19 provided little or no information with respect to CLD.…”

“…At the same time, identifying patients who are at risk of developing severe disease could help healthcare providers allocate their limited care resources more effectively in SARS-CoV-2infected communities. Previous retrospective studies reported an increased risk of developing more severe complications in COVID-19 patients with certain preexisting chronic diseases [2][3][4]. In addition, the development of acute organ damage and/or dysfunction has also been linked to increased severity and higher mortality rates among COVID-19 patients [2,[5][6][7][8][9][10][11][12][13][14][15][16].…”

Viral and atypical respiratory co‐infections in COVID‐19: a systematic review and meta‐analysis

“…Initial database searches resulted in 1766 publications of potential relevance with 1000 identified via Google Scholar, 316 publications identified via Medline/PubMed, 324 publications identified via EMBASE, 89 publications identified via Web of Science, 34 publications identified via Wiley's Cochrane Library, and 3 publications identified via OpenGrey (Figure 1; Supporting Information Table S2) At the full article screening stage, 6 study authors were contacted by mail regarding possible unpublished data from their studies with 1 responding that the data were unavailable. After title/abstract review and full text article screening, 19 articles were included in the final meta‐analysis with a total of 1880 patients 27–45 (Figure 2 and Table 1). Eleven included studies were from peer reviewed journals 28,29,31,34–38,40,41,45 .…”

JAK-Inhibitor and Type I Interferon Ability to Produce Favorable Clinical Outcomes in COVID-19 Patients: A Systematic Review and Meta-Analysis

“…In addition, two studies consistently demonstrated opposite associations between Type I interferon therapy and clinical outcomes, [30,33] when comparing summary statistics and other included studies. [28,29,31,34,35] Heterogeneity among populations studied may play a role in the disparate individual results, as half of these studies were conducted in China, one was conducted in Iran, five were conducted in Western Europe, and one was conducted in Cuba. Other irreconcilable factors that may have influenced patient outcomes included individual study exclusion criterion, as well as the dosage and delivery method of the intervention.…”

“…Meta-analysis of 3 sets of studies with 990, 454, and 1480 patients receiving Type I interferon therapy revealed that there were no significant associations between receiving Type I interferon therapy, compared to standard of care, and ICU admittance, requiring mechanical ventilation, or developing a severe or critical case of COVID-19, respectively (p>0.05; Figure 3B; Figure 3C; Figure 3D). [28][29][30][31][32][33][34][35][36] The analyses included 97, 167, and 537 control patients, respectively. The data exhibited very high heterogeneity in cases of ICU admittance and disease severity (both I 2 >90%), but relatively low in the case of mechanical ventilation (I 2 =12%).…”