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Market exposure was similar between the patients with intensive care unit care and those with non-intensive care unit care
Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.
The Lancet, no. 10223 (2020): 497-506
Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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- Coronaviruses are enveloped non-segmented positivesense RNA viruses belonging to the family Coronaviridae and the order Nidovirales and broadly distributed in humans and other mammals..
- In December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China, with clinical presentations greatly resembling viral pneumonia. Deep sequencing analysis from lower respiratory tract samples indicated a novel coronavirus, which was named 2019 novel coronavirus (2019-nCoV).
- More than 800 confirmed cases, including in health-care workers, have been identified in Wuhan, and several exported cases have been confirmed in other provinces in China, and in Thailand, Japan, South Korea, and the USA.[10–13]
- Coronaviruses are enveloped non-segmented positivesense RNA viruses belonging to the family Coronaviridae and the order Nidovirales and broadly distributed in humans and other mammals.
- In December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China, with clinical presentations greatly resembling viral pneumonia.
- We aim to describe epidemiological, clinical, laboratory, and radiological characteristics, treatment, and outcomes of patients confirmed to have 2019-nCoV infection, and to compare the clinical features between intensive care unit (ICU) and non-intensive care unit patients
- Patients Following the pneumonia cases of unknown cause reported in Wuhan and considering the shared history of exposure to Huanan seafood market across the patients, an epidemiological alert was released by the local health authority on Dec 31, 2019, and the market was shut down on Jan 1, 2020
- Since the cause was unknown at the onset of these emerging infections, the diagnosis of pneumonia of unknown cause in Wuhan was based on clinical characteristics, chest imaging, and the ruling out of common bacterial and viral pathogens that cause pneumonia
- Market exposure was similar between the patients with intensive care unit care and those with non-intensive care unit care (18 [64%])
- All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan.
- We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing.
- Suspected patients were isolated using airborne precautions in the designated hospital, Jin Yintan Hospital (Wuhan, China), and fit-tested N95 masks and airborne precautions for aerosol-generating procedures were taken.
- Written informed consent was waived by the Ethics Commission of the designated hospital for emerging infectious diseases
- By Jan 2, 2020, 41 admitted hospital patients were identified as laboratory-confirmed 2019-nCoV infection in Wuhan. 20 [49%]) of the 2019-nCoV-infected patients were aged 25–49 years, and 14 (34%) were aged 50–64 years.
- By Jan 2, 2020, 41 admitted hospital patients were identified as laboratory-confirmed 2019-nCoV infection in Wuhan.
- The symptom onset date of the first patient identified was Dec 1, 2019.
- None of his family members developed fever or any respiratory symptoms.
- The first fatal case, who had continuous exposure to the market, was admitted to hospital because of a 7-day history of fever, cough, and dyspnoea.
- The first fatal case, who had continuous exposure to the market, was admitted to hospital because of a 7-day history of fever, cough, and dyspnoea. 5 days after illness onset, his wife, a 53-year-old woman who had no known history of exposure to the market, presented with pneumonia and was hospitalised in the isolation ward
- We report here a cohort of 41 patients with laboratoryconfirmed 2019-nCoV infection.
- Sometimes fatal, pneumonia and were admitted to the designated hospital in Wuhan, China, by Jan 2, 2020.
- The time between hospital admission and ARDS was as short as 2 days.
- At this stage, the mortality rate is high for 2019-nCoV, because six (15%) of 41 patients in this cohort died.Background.
- Clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients
- Table1: Demographics and baseline characteristics of patients infected with 2019-nCoV
- Table2: Laboratory findings of patients infected with 2019-nCoV on admission to hospital some health-care workers have also been infected in Wuhan. Taken together, evidence so far indicates human transmission for 2019-nCoV. We are concerned that 2019-nCoV could have acquired the ability for efficient human transmission.[<a class="ref-link" id="c19" href="#r19">19</a>] Airborne precautions, such as a fit-tested N95 respirator, and other personal protective equipment are strongly recommended. To prevent further spread of the disease in health-care settings that are caring for patients infected with 2019-nCoV, onset of fever and respiratory symp toms should be closely monitored among health-care workers. Testing of respiratory specimens should be done immediately once a diagnosis is suspected. Serum antibodies should be tested among health-care workers www.thelancet.com Vol 395 February 15, 2020 before and after their exposure to 2019-nCoV for identification of asymptomatic infections
- Table3: Treatments and outcomes of patients infected with 2019-nCoV
- Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
- 1 Richman DD, Whitley RJ, Hayden FG, eds. Clinical virology, 4th edn. Washington: ASM Press, 2016.
- 2 Ksiazek TG, Erdman D, Goldsmith CS, et al. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med 2003; 348: 1953–66.
- 3 Kuiken T, Fouchier RAM, Schutten M, et al. Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome. Lancet 2003; 362: 263–70.
- 4 Drosten C, Günther S, Preiser W, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med 2003; 348: 1967–76.
- 5 de Groot RJ, Baker SC, Baric RS, et al. Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group. J Virol 2013; 87: 7790–92.
- 6 Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus ADME, Fouchier RAM. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 2012; 367: 1814–20.
- 7 WHO. Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003. Dec 31, 2003. https://www.who.int/csr/sars/country/table2004_04_21/en/ (accessed Jan 19, 2020).
- 8 WHO. Middle East respiratory syndrome coronavirus (MERS-CoV). November, 2019. http://www.who.int/emergencies/mers-cov/en/ (accessed Jan 19, 2020).
- 9 WHO. Novel coronavirus – China. Jan 12, 2020. http://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/ (accessed Jan 19, 2020).
- 10 WHO. Novel coronavirus – Thailand (ex-China). Jan 14, 2020. http://www.who.int/csr/don/14-january-2020-novel-coronavirusthailand/en/ (accessed Jan 19, 2020).
- 11 WHO. Novel coronavirus – Japan (ex-China). Jan 17, 2020. http://www.who.int/csr/don/17-january-2020-novel-coronavirusjapan-ex-china/en/ (accessed Jan 19, 2020).
- 12 WHO. Novel coronavirus – Republic of Korea (ex-China). Jan 21, 2020. http://www.who.int/csr/don/21-january-2020-novelcoronavirus-republic-of-korea-ex-china/en/ (accessed Jan 23, 2020).
- 13 CDC. First travel-related case of 2019 novel coronavirus detected in United States. Jan 21, 2020. https://www.cdc.gov/media/releases/2020/p0121-novel-coronavirus-travel-case.html (accessed Jan 23, 2020).
- 14 Tan W, Zhao X, Ma X, et al. A novel coronavirus genome identified in a cluster of pneumonia cases — Wuhan, China 2019−2020. http://weekly.chinacdc.cn/en/article/id/a3907201-f64f-4154-a19e4253b453d10c (accessed Jan 23, 2020).
- 15 Sanz F, Gimeno C, Lloret T, et al. Relationship between the presence of hypoxemia and the inflammatory response measured by C-reactive protein in bacteremic pneumococcal pneumonia. Eur Respir J 2011; 38 (suppl 55): 2492.
- 16 Kidney disease: improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. March, 2012. https://kdigo.org/wp-content/uploads/2016/10/ KDIGO-2012-AKI-Guideline-English.pdf (accessed Jan 23, 2020).
- 17 Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988; 16: 128–40.
- 18 Gao C, Wang Y, Gu X, et al. Association between cardiac injury and mortality in hospitalized patients infected with avian influenza A (H7N9) virus. Crit Care Med 2020; published online Jan 20. DOI:10.1097/CCM.0000000000004207.
- 19 Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis. Nat Rev Microbiol 2009; 7: 439–50.
- 20 Lee N, Hui D, Wu A, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003; 348: 1986–94.
- 21 Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis 2013; 13: 752–61.
- 22 Wong CK, Lam CWK, Wu AKL, et al. Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome. Clin Exp Immunol 2004; 136: 95–103.
- 23 Mahallawi WH, Khabour OF, Zhang Q, Makhdoum HM, Suliman BA. MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profile. Cytokine 2018; 104: 8–13.
- 24 He L, Ding Y, Zhang Q, et al. Expression of elevated levels of pro-inflammatory cytokines in SARS-CoV-infected ACE2+ cells in SARS patients: relation to the acute lung injury and pathogenesis of SARS. J Pathol 2006; 210: 288–97.
- 25 Faure E, Poissy J, Goffard A, et al. Distinct immune response in two MERS-CoV-infected patients: can we go from bench to bedside? PLoS One 2014; 9: e88716.
- 26 Falzarano D, de Wit E, Rasmussen AL, et al. Treatment with interferon-α2b and ribavirin improves outcome in MERS-CoVinfected rhesus macaques. Nat Med 2013; 19: 1313–17.
- 27 Stockman LJ, Bellamy R, Garner P. SARS: systematic review of treatment effects. PLoS Med 2006; 3: e343.
- 28 Lansbury L, Rodrigo C, Leonardi-Bee J, Nguyen-Van-Tam J, Lim WS. Corticosteroids as adjunctive therapy in the treatment of influenza. Cochrane Database Syst Rev 2019; 2: CD010406.
- 29 Arabi YM, Mandourah Y, Al-Hameed F, et al. Corticosteroid therapy for critically ill patients with Middle East respiratory syndrome. Am J Respir Crit Care Med 2018; 197: 757–67.
- 30 WHO. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. Jan 11, 2020. https://www.who.int/internal-publications-detail/clinicalmanagement-of-severe-acute-respiratory-infection-when-novelcoronavirus-(ncov)-infection-is-suspected (accessed Jan 19, 2020).
- 31 Chu CM. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax 2004; 59: 252–56.
- 32 Arabi YM, Alothman A, Balkhy HH, et al. Treatment of Middle East respiratory syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol for a randomized controlled trial. Trials 2018; 19: 81.
- 33 Sheahan TP, Sims AC, Graham RL, et al. Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Sci Transl Med 2017; 9: eaal3653.
- 34 Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020; 11: 222.
- 35 Cui J, Li F, Shi Z-L. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol 2019; 17: 181–92.
- 36 Ge X-Y, Li J-L, Yang X-L, et al. Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor. Nature 2013; 503: 535–38.
- 37 Wang M, Hu Z. Bats as animal reservoirs for the SARS coronavirus: hypothesis proved after 10 years of virus hunting. Virol Sin 2013; 28: 315–17.