Ann Transl Med . Diagnosis and treatment of 471 patients with 2019 novel coronavirus disease (COVID-19)

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Ann Transl Med


. 2021 Jan;9(2):163.
doi: 10.21037/atm-21-236.
Diagnosis and treatment of 471 patients with 2019 novel coronavirus disease (COVID-19)


Kebin Cheng ^{1 2} , Weining Xiong ³ , Xin Zhou ⁴ , Huiping Li ² , Junhua Zheng ⁵ , Jinfu Xu ²



Affiliations

• PMID: 33569465
• PMCID: PMC7867930
• DOI: 10.21037/atm-21-236

Abstract

Background: While the 2019 novel coronavirus disease (COVID-19) outbreak has been largely kept under control in China, it remains a global pandemic, and the source, transmission route, and treatments of SARS-COV-2 are still being investigated. Here, we summarized the clinical features, diagnosis, treatment, and prognosis of COVID-19 patients based on our clinical practice.
Methods: The clinical and imaging findings, treatments, and follow-up data of 471 patients with COVID-19 who were discharged from the Wuhan Jinyintan Hospital prior to February 6, 2020, were retrospectively analyzed.
Results: Among these patients, there were 2 mild cases, 282 moderate cases, 181 severe cases, and 6 critical cases. There were 250 males and 221 females aged 17 to 90 years. The median age was 54 years in the severe/critical group, which was significantly older than in the mild/moderate group (P<0.05). 44.59% of them had one or more underlying diseases. The most common symptoms were fever, cough, expectoration, and dyspnea. The median body temperature in the severe/critical group was 39?C, which was significantly higher than in the mild/moderate group (P<0.05). The incidences of lymphopenia and CD4⁺ T lymphocytopenia were 53.5% and 41.86%, respectively. Ground-glass opacity and small patchy shadows were the most common findings on chest computed tomography (CT). Compared with the mild/moderate group, the severe/critical group showed higher proportions of severe lymphocytopenia and CD4⁺ T lymphocytopenia, along with more ground-glass shadows and large-scale consolidation. After anti-infection, oxygen therapy, and symptomatic support, lymphocytes and CD4⁺ T lymphocytes were markedly increased, all patients were discharged. The median time of nucleic acid conversion and hospital stay were 9 and 12 days, respectively, which were significantly longer in the severe/critical group than in the mild/moderate group. Of the 390 cases followed, only 19 were hospitalized again due to other diseases. All patients recovered well from COVID-19, with negative nucleic acid test results.
Conclusions: Lymphocytopenia and CD4⁺ T lymphocytopenia were found to be associated with COVID-19 and thus may be important indicators in evaluating the severity and prognosis. Multidisciplinary management including antiviral treatment, immune regulation, and symptomatic support is effective, and yields a low recurrence rate.

Keywords: 2019 novel coronavirus disease (COVID-19); clinical characteristics; lymphocyte; prognosis; treatment.