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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

Cited by: 0|Views154
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Abstract

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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Introduction
  • 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.[1].
  • In December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China, with clinical presentations greatly resembling viral pneumonia.[9] 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.[1013]
Highlights
  • 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.[1]
  • In December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China, with clinical presentations greatly resembling viral pneumonia.[9]
  • 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%])
Methods
  • 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
Results
  • 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
Conclusion
  • 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
Tables
  • 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
Download tables as Excel
Funding
  • Funding 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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Author
Chaolin Huang
Chaolin Huang
Yeming Wang
Yeming Wang
Xingwang Li
Xingwang Li
Yi Hu
Yi Hu
Li Zhang
Li Zhang
Guohui Fan
Guohui Fan
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