Pub Date : 2020-04-20DOI: 10.3760/CMA.J.CN311365-20200228-00160
Xinxin Wang, C. Shao, Hui Liu, Lingjiao Meng, F. Lyu
Objective To observe the morphological features of lungs in patients with critical 2019 corona virus disease (COVID-19), and to analyze the clinical-pathological relationship. Methods Two critical patients with COVID-19 who died in Beijing You'an Hospital affiliated to Capital Medical University on February 13 and 14, 2020, respectively were examined by bilateral lungs biopsy. The obtained samples were dehydrated, paraffin embedded, sectioned, stained with hematoxylin-eosin as routine methods, and then observed under light microscope. Results The pulmonary morphology changes of patients with COVID-19 showed diffuse alveolar damage. Case one was an elderly patient with underlying diseases and his lesions were mainly exudation and hyaline membrane formation, which showed an acute exudation stage of diffuse alveolar damage. Case two was a patient without underlying diseases and his pathological changes were diffuse inflammatory cell infiltration, extensive fibrosis of alveolar wall, filling of necrotizing inflammatory cellulosic exudate in alveolar airspace, extensive destruction of alveoli and pulmonary consolidation, which was characterized by organized stage of diffuse alveolar damage complicated with bacterial pneumonia. The injury of paracronchial submucosal gland was not observed in the two patients. Conclusions Diffused alveolar damage is the main pathological feature of critical COVID-19. Diffused alveolar damage can induce or aggravate the underlying diseases of elderly patients in the early stage. Extensive destruction of alveoli, pulmonary consolidation and secondary infection are the main causes of respiratory failure in the late stage. Key words: Coronavirus infections; Pneumonia; Pathology; 2019-nCoV; COVID-19; Lung tissue
{"title":"Morphological characteristics of lung tissue in two cases with critical corona virus disease 2019","authors":"Xinxin Wang, C. Shao, Hui Liu, Lingjiao Meng, F. Lyu","doi":"10.3760/CMA.J.CN311365-20200228-00160","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200228-00160","url":null,"abstract":"Objective \u0000To observe the morphological features of lungs in patients with critical 2019 corona virus disease (COVID-19), and to analyze the clinical-pathological relationship. \u0000 \u0000 \u0000Methods \u0000Two critical patients with COVID-19 who died in Beijing You'an Hospital affiliated to Capital Medical University on February 13 and 14, 2020, respectively were examined by bilateral lungs biopsy. The obtained samples were dehydrated, paraffin embedded, sectioned, stained with hematoxylin-eosin as routine methods, and then observed under light microscope. \u0000 \u0000 \u0000Results \u0000The pulmonary morphology changes of patients with COVID-19 showed diffuse alveolar damage. Case one was an elderly patient with underlying diseases and his lesions were mainly exudation and hyaline membrane formation, which showed an acute exudation stage of diffuse alveolar damage. Case two was a patient without underlying diseases and his pathological changes were diffuse inflammatory cell infiltration, extensive fibrosis of alveolar wall, filling of necrotizing inflammatory cellulosic exudate in alveolar airspace, extensive destruction of alveoli and pulmonary consolidation, which was characterized by organized stage of diffuse alveolar damage complicated with bacterial pneumonia. The injury of paracronchial submucosal gland was not observed in the two patients. \u0000 \u0000 \u0000Conclusions \u0000Diffused alveolar damage is the main pathological feature of critical COVID-19. Diffused alveolar damage can induce or aggravate the underlying diseases of elderly patients in the early stage. Extensive destruction of alveoli, pulmonary consolidation and secondary infection are the main causes of respiratory failure in the late stage. \u0000 \u0000 \u0000Key words: \u0000Coronavirus infections; Pneumonia; Pathology; 2019-nCoV; COVID-19; Lung tissue","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41436844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-16DOI: 10.3760/CMA.J.CN311365-20200316-00314
Jiming Zhang, F. Sun, Xinlong Ma, Bo Jia, Minjie Yang, Yin Wei, A. Zhang, Yang Li, J. Wan, Wenhong Zhang
Wuhan is the city with the most serious outbreak of corona virus disease 2019 (COVID-19) in China. The outbreak of community has exhausted the current medical resources. With integrating local and support medical resources from other province, Wuhan City has rapidly rebuilt a new emergency medical system of classified treatment, and effectively responded to the overload medical demand after the outbreak in the community.
{"title":"Establishing emergency medical system of classified treatment to alleviate the overload medical needs after the community outbreak of corona virus disease 2019 in Wuhan City","authors":"Jiming Zhang, F. Sun, Xinlong Ma, Bo Jia, Minjie Yang, Yin Wei, A. Zhang, Yang Li, J. Wan, Wenhong Zhang","doi":"10.3760/CMA.J.CN311365-20200316-00314","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200316-00314","url":null,"abstract":"Wuhan is the city with the most serious outbreak of corona virus disease 2019 (COVID-19) in China. The outbreak of community has exhausted the current medical resources. With integrating local and support medical resources from other province, Wuhan City has rapidly rebuilt a new emergency medical system of classified treatment, and effectively responded to the overload medical demand after the outbreak in the community.","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43122015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-02DOI: 10.3760/CMA.J.CN311365-20200304-00208
Ming Liu, F. Lin, Jiao Wang, Chao-Lang Wei, Jia-Xin Tian, Juan Fu, S. Zhong, Xinping Chen, Li-su Han, Hui Li, Jing Cao, Suo-Xian Chen, Fu-rong Xiao, Yongxing Chen, Zhongyi Zhou, Xiaohong Xie, Tao Wu
Objective To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). Methods The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed. RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine. The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared. The t test was used for comparison of normally distributed continuous data between groups. Results There were eight males (88.9%) and 1 female enrolled. The patients aged 28-77 years old, with an age of (52.9±18.0) years. By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition. All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset). The white blood cell counts ((13.52±8.24)×109/L vs (10.49±4.46) ×109/L), C-reactive protein ((139.71±87.46) mg/L vs (78.60±55.40) mg/L) and procalcitonin ((2.32±4.03) ng/mL vs (0.28±0.58) ng/mL) , lactic acid ((3.70±4.14) mmol/L vs (2.33±0.53) mmol/L) in deteriorated group were all significantly higher than those in improved group (t=2.908, 5.009, 4.391 and 2.942, respectively, all P<0.01). A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death. Conclusion Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases. Key words: Coronavirus infection; Pneumonia; Coronavirus disease 2019; Critical type; Nucleic acid testing; Inflammatory cytokine
{"title":"Clinical analysis of nine cases with critical corona virus disease 2019 in Hainan province/ 中华传染病杂志","authors":"Ming Liu, F. Lin, Jiao Wang, Chao-Lang Wei, Jia-Xin Tian, Juan Fu, S. Zhong, Xinping Chen, Li-su Han, Hui Li, Jing Cao, Suo-Xian Chen, Fu-rong Xiao, Yongxing Chen, Zhongyi Zhou, Xiaohong Xie, Tao Wu","doi":"10.3760/CMA.J.CN311365-20200304-00208","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200304-00208","url":null,"abstract":"Objective \u0000To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). \u0000 \u0000 \u0000Methods \u0000The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed. RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine. The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared. The t test was used for comparison of normally distributed continuous data between groups. \u0000 \u0000 \u0000Results \u0000There were eight males (88.9%) and 1 female enrolled. The patients aged 28-77 years old, with an age of (52.9±18.0) years. By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition. All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset). The white blood cell counts ((13.52±8.24)×109/L vs (10.49±4.46) ×109/L), C-reactive protein ((139.71±87.46) mg/L vs (78.60±55.40) mg/L) and procalcitonin ((2.32±4.03) ng/mL vs (0.28±0.58) ng/mL) , lactic acid ((3.70±4.14) mmol/L vs (2.33±0.53) mmol/L) in deteriorated group were all significantly higher than those in improved group (t=2.908, 5.009, 4.391 and 2.942, respectively, all P<0.01). A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death. \u0000 \u0000 \u0000Conclusion \u0000Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases. \u0000 \u0000 \u0000Key words: \u0000Coronavirus infection; Pneumonia; Coronavirus disease 2019; Critical type; Nucleic acid testing; Inflammatory cytokine","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45252681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-18DOI: 10.3760/CMA.J.CN311365-20200211-00055
Y. Ling, Yixiao Lin, Z. Qian, Dan Huang, Dandan Zhang, Tao Li, Min Liu, Shuli Song, Jun Wang, Y. Zhang, Shuibao Xu, Jun Chen, Jianliang Zhang, T. Zhu, Bijie Hu, Sheng Wang, E. Mao, Lei Zhu, Hongzhou Lu
Objective To analyze the clinical features of patients with coronavirus disease 2019 (COVID-19) in Shanghai and to investigate the risk factors for disease progression to severe cases. Methods The clinical data of 292 adult patients with COVID-19 hospitalized in Shanghai Public Health Clinical Center from January 20, 2020 to February 10, 2020 were retrospectively analyzed, including 21 severe patients and 271 mild patients. The demographic characteristics, epidemiological history, history of underlying diseases and laboratory examinations were compared between the two groups. Measurement data were compared using t test or Mann-Whitney U test. The count data were compared using hi-square test. The binary logistic regression equation was used to analyze the risk factors for the progression of patients to severe cases. Results Among the 292 patients, 21 were severe cases with the rate of 7.2% (21/292). One patient died, and the mortality rate was 4.8% in severe patients. The severe patients aged (65.0±15.7) years old, 19 (90.5%) were male, 11 (52.4%) had underlying diseases, 7 (33.3%) had close relatives diagnosed with COVID-19. The mild patients aged (48.7±15.7) years old, 135 (49.8%) were male, 74 (27.3%) had underlying diseases, 36 (13.3%) had close relatives diagnosed with COVID-19. The differences between two groups were all significant statistically ( t =-4.730, χ 2 =12.930, 5.938 and 4.744, respectively, all P <0.05). Compared with the mild patients, the levels of absolute numbers of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine, serum cystatin C, C reactive protein (CRP), procalcitonin , D -dimer, pro-B-type natriuretic peptide (proBNP), serum myoglobin, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), serum troponin I (cTnI) in severe patients were all significantly higher ( U =2 091.5, 1 928.0, 1 215.5, 729.0, 1 580.5, 1 375.5, 917.5, 789.5, 1 209.0, 1 434.0, 638.0, 964.5, 1 258.0 and 1 747.5, respectively, all P <0.05), while the levels of lymphocyte count, albumin, transferrin, CD3 + T lymphocyte count, CD8 + T lymphocyte count and CD4 + T lymphocyte count in severe patients were all significantly lower ( U =1 263.5, t =4.716, U =1 214.0, 962.0, 1 167.5 and 988.0, respectively, all P <0.05). Further logistic regression analysis showed that the albumin (odds ratio ( OR )=0.806, 95% CI 0.675-0.961), CRP ( OR =1.016, 95% CI 1.000-1.032), serum myoglobin ( OR =1.010, 95% CI 1.004-1.016), CD3 + T lymphocyte count ( OR =0.996, 95% CI 0.991-1.000) and CD8 + T lymphocyte count ( OR =1.006, 95% CI 1.001-1.010) at admission were independent risk factors for the progression of COVID-19 patients to severe illness (all P <0.05). Conclusions Severe cases of patients with COVID-19 in Shanghai are predominantly elderly men with underlying diseases. Albumin, CRP, serum myoglobin, CD3 + T lymphocyte count and CD8 + T lymphocyte count could be used as early warning indicators for severe cases,
{"title":"Clinical analysis of risk factors for severe patients with novel coronavirus pneumonia","authors":"Y. Ling, Yixiao Lin, Z. Qian, Dan Huang, Dandan Zhang, Tao Li, Min Liu, Shuli Song, Jun Wang, Y. Zhang, Shuibao Xu, Jun Chen, Jianliang Zhang, T. Zhu, Bijie Hu, Sheng Wang, E. Mao, Lei Zhu, Hongzhou Lu","doi":"10.3760/CMA.J.CN311365-20200211-00055","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200211-00055","url":null,"abstract":"Objective To analyze the clinical features of patients with coronavirus disease 2019 (COVID-19) in Shanghai and to investigate the risk factors for disease progression to severe cases. Methods The clinical data of 292 adult patients with COVID-19 hospitalized in Shanghai Public Health Clinical Center from January 20, 2020 to February 10, 2020 were retrospectively analyzed, including 21 severe patients and 271 mild patients. The demographic characteristics, epidemiological history, history of underlying diseases and laboratory examinations were compared between the two groups. Measurement data were compared using t test or Mann-Whitney U test. The count data were compared using hi-square test. The binary logistic regression equation was used to analyze the risk factors for the progression of patients to severe cases. Results Among the 292 patients, 21 were severe cases with the rate of 7.2% (21/292). One patient died, and the mortality rate was 4.8% in severe patients. The severe patients aged (65.0±15.7) years old, 19 (90.5%) were male, 11 (52.4%) had underlying diseases, 7 (33.3%) had close relatives diagnosed with COVID-19. The mild patients aged (48.7±15.7) years old, 135 (49.8%) were male, 74 (27.3%) had underlying diseases, 36 (13.3%) had close relatives diagnosed with COVID-19. The differences between two groups were all significant statistically ( t =-4.730, χ 2 =12.930, 5.938 and 4.744, respectively, all P <0.05). Compared with the mild patients, the levels of absolute numbers of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine, serum cystatin C, C reactive protein (CRP), procalcitonin , D -dimer, pro-B-type natriuretic peptide (proBNP), serum myoglobin, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), serum troponin I (cTnI) in severe patients were all significantly higher ( U =2 091.5, 1 928.0, 1 215.5, 729.0, 1 580.5, 1 375.5, 917.5, 789.5, 1 209.0, 1 434.0, 638.0, 964.5, 1 258.0 and 1 747.5, respectively, all P <0.05), while the levels of lymphocyte count, albumin, transferrin, CD3 + T lymphocyte count, CD8 + T lymphocyte count and CD4 + T lymphocyte count in severe patients were all significantly lower ( U =1 263.5, t =4.716, U =1 214.0, 962.0, 1 167.5 and 988.0, respectively, all P <0.05). Further logistic regression analysis showed that the albumin (odds ratio ( OR )=0.806, 95% CI 0.675-0.961), CRP ( OR =1.016, 95% CI 1.000-1.032), serum myoglobin ( OR =1.010, 95% CI 1.004-1.016), CD3 + T lymphocyte count ( OR =0.996, 95% CI 0.991-1.000) and CD8 + T lymphocyte count ( OR =1.006, 95% CI 1.001-1.010) at admission were independent risk factors for the progression of COVID-19 patients to severe illness (all P <0.05). Conclusions Severe cases of patients with COVID-19 in Shanghai are predominantly elderly men with underlying diseases. Albumin, CRP, serum myoglobin, CD3 + T lymphocyte count and CD8 + T lymphocyte count could be used as early warning indicators for severe cases, ","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48266946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-17DOI: 10.3760/CMA.J.CN311365-20200220-00094
Yingdi Hu, Guanzhu Lu, Jie Xu
Some patients with 2019-novel coronavirus (2019-nCoV) may present with gastrointestinal symptoms of nausea, vomiting, abdominal pain, and diarrhea. Even a few patients have gastrointestinal symptoms as the first manifestation. Now we will elaborate and think about the possible mechanism of digestive tract symptoms caused by 2019-nCoV, the intestinal mucosal barrier effect and the outcome of intestinal flora alternation. Key words: coronavirus infections; gastrointestinal tract; SARS-CoV-2
{"title":"Exploration of digestive tract symptoms causesd by the novel coronavirus infection","authors":"Yingdi Hu, Guanzhu Lu, Jie Xu","doi":"10.3760/CMA.J.CN311365-20200220-00094","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200220-00094","url":null,"abstract":"Some patients with 2019-novel coronavirus (2019-nCoV) may present with gastrointestinal symptoms of nausea, vomiting, abdominal pain, and diarrhea. Even a few patients have gastrointestinal symptoms as the first manifestation. Now we will elaborate and think about the possible mechanism of digestive tract symptoms caused by 2019-nCoV, the intestinal mucosal barrier effect and the outcome of intestinal flora alternation. \u0000 \u0000 \u0000Key words: \u0000coronavirus infections; gastrointestinal tract; SARS-CoV-2","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44428131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the specific chest computed tomography (CT) features of corona virus disease 2019(COVID-19) and to evaluate its clinical diagnostic value. Methods The clinical data of 35 cases with suspected novel coronavirus pneumonia diagnosed from Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine and Oriental Hospital affiliated to Shanghai Tongji University School of Medicine from January 1, 2020 to February 14, 2020 were retrospectively analyzed. A total of 17 cases with positive results of two times of real time reverse-transcription–polymerase chain-reaction (RT-PCR) for 2019 novel coronavirus (2019-nCoV) were evaluated as the case group, and the remaining 18 cases with negative results of two times of RT-PCR for 2019-nCoV were evaluated as the control group. The features of chest CT images of 35 cases were obtained. The frequencies of four CT imaging indicators including ground-glass opacities (GGO), crazy-paving , heterogeneous consolidation and bilateral subpleural distribution were analyzed. The sensitivity, specificity, positive predictive values (PPV) and negative predictive value (NPV) for COVID-19 were calculated. Results In the case group, there were 11 cases (64.71%) with GGO, 7 cases (41.18%) with crazy-paving, 6 cases (35.29%) with heterogeneous consolidation, and 16 cases (94.12%) with bilateral subpleural distribution, while in the control group, there were 7 cases (27.28%) with GGO, 1 case (5.56%) with crazy-paving, 6 cases (33.33%) with heterogeneous consolidation, and 5 cases (29.41%) with bilateral subpleural distribution. When multiple subpleural lesions or any two of the CT indicators were used as the characteristic indicator, the diagnosis efficiencies were better, with the sensitivity, specificity, PPV, NPV and Youden index of 94.12%, 72.22%, 76.19%, 98.86% and 0.66, respectively, and 88.24%, 77.78%, 78.95%, 87.5% and 0.66, respectively. Conclusions Chest CT indictors are of high clinical diagnostic value for COVID-19. Any two of the four CT indicators (GGO, crazy-paving, heterogeneous consolidation and bilateral subpleural distribution) or the single characteristics (bilateral subpleural distribution) are of high diagnostic efficacy. Key words: COVID-19; Computed tomography
{"title":"Clinical diagnostic value of computed tomography features of corona virus disease 2019 in 17 cases","authors":"Yu Wu, Ya-fang Dou, Songhua Zhan, Shuguang Chu, Ailan Cheng, Dongqin Zhang","doi":"10.3760/CMA.J.CN311365-20200219-00088","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200219-00088","url":null,"abstract":"Objective \u0000To investigate the specific chest computed tomography (CT) features of corona virus disease 2019(COVID-19) and to evaluate its clinical diagnostic value. \u0000 \u0000 \u0000Methods \u0000The clinical data of 35 cases with suspected novel coronavirus pneumonia diagnosed from Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine and Oriental Hospital affiliated to Shanghai Tongji University School of Medicine from January 1, 2020 to February 14, 2020 were retrospectively analyzed. A total of 17 cases with positive results of two times of real time reverse-transcription–polymerase chain-reaction (RT-PCR) for 2019 novel coronavirus (2019-nCoV) were evaluated as the case group, and the remaining 18 cases with negative results of two times of RT-PCR for 2019-nCoV were evaluated as the control group. The features of chest CT images of 35 cases were obtained. The frequencies of four CT imaging indicators including ground-glass opacities (GGO), crazy-paving , heterogeneous consolidation and bilateral subpleural distribution were analyzed. The sensitivity, specificity, positive predictive values (PPV) and negative predictive value (NPV) for COVID-19 were calculated. \u0000 \u0000 \u0000Results \u0000In the case group, there were 11 cases (64.71%) with GGO, 7 cases (41.18%) with crazy-paving, 6 cases (35.29%) with heterogeneous consolidation, and 16 cases (94.12%) with bilateral subpleural distribution, while in the control group, there were 7 cases (27.28%) with GGO, 1 case (5.56%) with crazy-paving, 6 cases (33.33%) with heterogeneous consolidation, and 5 cases (29.41%) with bilateral subpleural distribution. When multiple subpleural lesions or any two of the CT indicators were used as the characteristic indicator, the diagnosis efficiencies were better, with the sensitivity, specificity, PPV, NPV and Youden index of 94.12%, 72.22%, 76.19%, 98.86% and 0.66, respectively, and 88.24%, 77.78%, 78.95%, 87.5% and 0.66, respectively. \u0000 \u0000 \u0000Conclusions \u0000Chest CT indictors are of high clinical diagnostic value for COVID-19. Any two of the four CT indicators (GGO, crazy-paving, heterogeneous consolidation and bilateral subpleural distribution) or the single characteristics (bilateral subpleural distribution) are of high diagnostic efficacy. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Computed tomography","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47227124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-09DOI: 10.3760/CMA.J.CN311365-20200218-00081
Xuli Yang, Zhihui Wang, Xing Liu, Shanshan Wu, Xiaoping Wu, G. Wen, Xianjun Zeng, Huawei Xiong, JIe Liu, Tao Hong
Objective To evaluate the diagnostic efficacies of computed tomography (CT), clinical manifestations and 2019 novel coronavirus (2019-nCoV) nucleic acid test results for the screening and diagnosis of novel coronavirus pneumonia. Methods The clinical data of cases suspected with coronavirus disease 2019 (COVID-19) visited fever clinic or stayed in emergency room of the First Affiliated Hospital of Nanchang University from January 23, 2020 to February 9, 2020 were collected. Totally 274 cases who met the inclusion criteria were enrolled. Four screening schemes including chest CT screening, scoring, chest CT and scoring series screening, chest CT and scoring parallel screening were designed. The statistical analysis was performed by using chi-square test. The sensitivities, specificities and the areas under the receiver operator characteristic curve of the four screening schemes were calculated, and the diagnostic efficacies were evaluated. Results Among the 274 cases, 93.80% (257/274) presented with typical clinical symptoms, 47.81% (131/274) had epidemiological history, and the blood routine examination results of 45.26% (124/274) cases met the positive criteria of the scoring , and chest CT results of 43.07% (118/274) cases met the positive criteria of chest CT screening. The 2019-nCoV nucleic acid test positive rate of cases with epidemiological history was 30.53% (40/131), which was higher than that of cases without epidemiological history (9.09% (13/143)) , and that of cases with typical imaging performance on chest CT was 40.68% (48/118), which was higher than cases without typical imaging performance (3.21% (5/156)) . The differences between the above groups were both statistically significant (both P<0.01). The positive rates of viral nucleic acid detection in cases with positive findings of chest CT screening, scoring, series screening, and parallel screening were 40.68% (48/118), 23.74% (47/198), 4.25% (42/94) and 23.87% (53/222), respectively, while those in cases with negative findings of the four screening schemes were 3.20% (5/156), 7.89% (6/76), 6.11% (11/180) and 0 (0/52), respectively. The positive rates of the four screening schemes were all significantly different from that of viral nucleic acid detection (all P<0.01). The chest CT screening method had a sensitivity of 90.57%, a specificity of 68.33%, and an area under the operating characteristic curve of the subject was 0.794, which had higher diagnostic value than those of the other three screening schemes. Conclusions For the screening and diagnosis of COVID-19 cases, epidemiological history, positive viral nucleic acid test with ≥2 typical clinical manifestations have highly diagnostic value. On the basis of the preliminary screening of chest CT examination, flexible analysis of the diagnostic results could improve the diagnostic value of each detection method. Key words: COVID-19; Pneumonia; Chest CT; Real-time polymerase chain reaction; Screening
{"title":"Screening for 274 suspected cases of novel coronavirus pneumonia","authors":"Xuli Yang, Zhihui Wang, Xing Liu, Shanshan Wu, Xiaoping Wu, G. Wen, Xianjun Zeng, Huawei Xiong, JIe Liu, Tao Hong","doi":"10.3760/CMA.J.CN311365-20200218-00081","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200218-00081","url":null,"abstract":"Objective \u0000To evaluate the diagnostic efficacies of computed tomography (CT), clinical manifestations and 2019 novel coronavirus (2019-nCoV) nucleic acid test results for the screening and diagnosis of novel coronavirus pneumonia. \u0000 \u0000 \u0000Methods \u0000The clinical data of cases suspected with coronavirus disease 2019 (COVID-19) visited fever clinic or stayed in emergency room of the First Affiliated Hospital of Nanchang University from January 23, 2020 to February 9, 2020 were collected. Totally 274 cases who met the inclusion criteria were enrolled. Four screening schemes including chest CT screening, scoring, chest CT and scoring series screening, chest CT and scoring parallel screening were designed. The statistical analysis was performed by using chi-square test. The sensitivities, specificities and the areas under the receiver operator characteristic curve of the four screening schemes were calculated, and the diagnostic efficacies were evaluated. \u0000 \u0000 \u0000Results \u0000Among the 274 cases, 93.80% (257/274) presented with typical clinical symptoms, 47.81% (131/274) had epidemiological history, and the blood routine examination results of 45.26% (124/274) cases met the positive criteria of the scoring , and chest CT results of 43.07% (118/274) cases met the positive criteria of chest CT screening. The 2019-nCoV nucleic acid test positive rate of cases with epidemiological history was 30.53% (40/131), which was higher than that of cases without epidemiological history (9.09% (13/143)) , and that of cases with typical imaging performance on chest CT was 40.68% (48/118), which was higher than cases without typical imaging performance (3.21% (5/156)) . The differences between the above groups were both statistically significant (both P<0.01). The positive rates of viral nucleic acid detection in cases with positive findings of chest CT screening, scoring, series screening, and parallel screening were 40.68% (48/118), 23.74% (47/198), 4.25% (42/94) and 23.87% (53/222), respectively, while those in cases with negative findings of the four screening schemes were 3.20% (5/156), 7.89% (6/76), 6.11% (11/180) and 0 (0/52), respectively. The positive rates of the four screening schemes were all significantly different from that of viral nucleic acid detection (all P<0.01). The chest CT screening method had a sensitivity of 90.57%, a specificity of 68.33%, and an area under the operating characteristic curve of the subject was 0.794, which had higher diagnostic value than those of the other three screening schemes. \u0000 \u0000 \u0000Conclusions \u0000For the screening and diagnosis of COVID-19 cases, epidemiological history, positive viral nucleic acid test with ≥2 typical clinical manifestations have highly diagnostic value. On the basis of the preliminary screening of chest CT examination, flexible analysis of the diagnostic results could improve the diagnostic value of each detection method. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Pneumonia; Chest CT; Real-time polymerase chain reaction; Screening","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45423046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-05DOI: 10.3760/CMA.J.CN311365-20200218-00076
Dandan Li, Hongyan Liu, Yan Wang, H. Guo, Kai Wang, R. Zhao, Yunhai Wu, Xinghai Li
Objective@#To analyze the epidemiological and clinical characteristics of patients with 2019 novel coronavirus (2019-nCoV) infection in Shenyang.@*Methods@#The epidemiological and clinical characteristics of 30 patients diagnosed with 2019-nCoV infection admitted to Shenyang sixth people's hospital on January 22, 2020 and February 8, 2020 were retrospectively analyzed.@*Results@#Among the 30 cases, 21 were imported, including 17 from Hubei Province and four from other provinces. Nine cases were local infections. There were 18 men and 12 women, aging from 21 to 72 years with the median of 43 years. Eight cases had underlying diseases including hypertension, diabetes, coronary heart disease and bronchitis. On admission, two (7%) cases were mild, 19 (63%) cases were ordinary, eight (27%) cases were severe, and one (3%) case was critical. Clinical manifestations mainly include fever, with or without upper respiratory tract symptoms, normal, decreased or slightly increased white blood cell counts, mainly decreased lymphocyte counts, normal or increased c-reactive protein, and normal procalcitonin. The computed tomography (CT) of the early stage of the lungs showed that multiple patchy ground glass shadows were mainly accompanied by consolidation, which often involved both lungs or multiple lobes of one lung. At the moment, the clinical treatment mainly included respiratory support, symptomatic treatment, antiviral treatment adn anti-bacterial treatment. By February 15, a total of nine cases were cured and discharged, including one mild case, six ordinary cases, and two severe cases. In the comparisons between mild/ordinary patients and severe/critical patients, the fever duration in the severe/critical group (median 11.5 d) was significantly longer than that in the light/normal group (median 2 d) (Z=-2.292, P=0.022), and the laboratory tests indicated elevated d-dimer levels (Z=-2.669, P=0.008) and more cases with neutrophilic/lymphocyte ratio > 3 (Z=-4.071, P 3 could be used as early warning indicators for severe cases.
{"title":"Clinical features of 30 cases with novel coronavirus pneumonia/ 中华传染病杂志","authors":"Dandan Li, Hongyan Liu, Yan Wang, H. Guo, Kai Wang, R. Zhao, Yunhai Wu, Xinghai Li","doi":"10.3760/CMA.J.CN311365-20200218-00076","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200218-00076","url":null,"abstract":"Objective@#To analyze the epidemiological and clinical characteristics of patients with 2019 novel coronavirus (2019-nCoV) infection in Shenyang.@*Methods@#The epidemiological and clinical characteristics of 30 patients diagnosed with 2019-nCoV infection admitted to Shenyang sixth people's hospital on January 22, 2020 and February 8, 2020 were retrospectively analyzed.@*Results@#Among the 30 cases, 21 were imported, including 17 from Hubei Province and four from other provinces. Nine cases were local infections. There were 18 men and 12 women, aging from 21 to 72 years with the median of 43 years. Eight cases had underlying diseases including hypertension, diabetes, coronary heart disease and bronchitis. On admission, two (7%) cases were mild, 19 (63%) cases were ordinary, eight (27%) cases were severe, and one (3%) case was critical. Clinical manifestations mainly include fever, with or without upper respiratory tract symptoms, normal, decreased or slightly increased white blood cell counts, mainly decreased lymphocyte counts, normal or increased c-reactive protein, and normal procalcitonin. The computed tomography (CT) of the early stage of the lungs showed that multiple patchy ground glass shadows were mainly accompanied by consolidation, which often involved both lungs or multiple lobes of one lung. At the moment, the clinical treatment mainly included respiratory support, symptomatic treatment, antiviral treatment adn anti-bacterial treatment. By February 15, a total of nine cases were cured and discharged, including one mild case, six ordinary cases, and two severe cases. In the comparisons between mild/ordinary patients and severe/critical patients, the fever duration in the severe/critical group (median 11.5 d) was significantly longer than that in the light/normal group (median 2 d) (Z=-2.292, P=0.022), and the laboratory tests indicated elevated d-dimer levels (Z=-2.669, P=0.008) and more cases with neutrophilic/lymphocyte ratio > 3 (Z=-4.071, P 3 could be used as early warning indicators for severe cases.","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44669222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig) M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance. Methods A total of 278 patients who were treated at Wuhan Hankou Hospital and the People's Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with 2019-nCoV nucleic acid positive diagnosis, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant N protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed. Results The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8% (113/189) and 52.9% (100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1% (125/189). Conclusion This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR. Key words: Coronavirus infection; Novel coronavirus; Gold colloid; Antibodies; Clinical performance
{"title":"Establishment and clinical performance evaluation of 2019 novel coronavirus antibody colloidal gold detection method/ 中华传染病杂志","authors":"Hui Li, Yongyin Li, Zhigao Zhang, Zhen Lu, Yi Wang, Guanfeng Lin, Taixue An, Xiumei Hu, Q. Lai, Xuan Yi, Zhihong Liu, Xiangming Zhai, Jian Sun, Yabing Guo, Jiatao Lu, Xiaoyong Zhang, Yingsong Wu, Jinlin Hou","doi":"10.3760/CMA.J.CN311365-20200221-00101","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200221-00101","url":null,"abstract":"Objective \u0000To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig) M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance. \u0000 \u0000 \u0000Methods \u0000A total of 278 patients who were treated at Wuhan Hankou Hospital and the People's Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with 2019-nCoV nucleic acid positive diagnosis, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant N protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed. \u0000 \u0000 \u0000Results \u0000The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8% (113/189) and 52.9% (100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1% (125/189). \u0000 \u0000 \u0000Conclusion \u0000This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR. \u0000 \u0000 \u0000Key words: \u0000Coronavirus infection; Novel coronavirus; Gold colloid; Antibodies; Clinical performance","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141225198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-27DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.0015
Shi Chen, Juan Wu, Zhi Ming Li, Dixiong Xu, Ziyang Zhu, Chuanhai Wang, Cheng-hong Li, P. He
Objective To observe theepidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with novel coronavirus pneumonia. Methods Clinical data of 109 patients with suspected and definite novel coronavirus pneumonia admitted to Wuhan Sixth Hospital from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysiswas performed by using t test or chi-square test. Results Among the 109 patients, 48 (44%) were male and 61 (56%) were female, with the average age of (52.5±10.8) years. Fifty-four patients (49.5%) had definite contact history. Among the 109 patients, 104 (95.5%) presentedwith fever, 37(33.7%) with headache, 78 (71.9%) with general pain, 88 (80.8%) with fatigue and poor appetite, 23 (21.3%) with diarrhea, 94 (86.5%) withcoughing, 23 (21.3%) with shortness of breath, 57 (52.8%) withpalpitation, 45 (41.5%) with chest distress, 4 (3.3%) with chest pain, 40 (37.0%) with lung rales. Forty-two cases (38.5%) had leukocyte count 230 mmol/L, 29 cases (26.6%) had brain natriuretic peptide precursor>300 ng/mL, 87 cases (79.8%) had hypersensitive C-reactive protein >10mg/L, 26 cases (23.9%) had D-dimer >0.5 mg/L, 35 cases (32.1%) had coagulation disorder. The leukocyte counts, LDH, brain natriuretic peptide precursor and D-dimer of severe/critical cases[(11.33±4.87)×109/L, (527.51±260.87) mmol/L, (722.88±189.56) ng/mL, (1.89±4.24) mg/L, respectively] were all significantly higher than those of common cases [(4.02±1.49)×109/L, (159.75±30.31)mmol/L, (428.22±124.76)ng/mLand (0.41±0.22)mg/L, respectively], while the lymphocyte count of severe/critical cases [(0.60±0.17)×109/L] was significantly lower than common cases [(1.13±0.43)×109/L] (t=11.36, 11.33,9.81,2.81 and 7.77,all P<0.05). On admission, chest CT showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) werebilateral, and most of them were ground glass. The pneumonia progressed in a short time and reached the peak within 10 days. The comprehensive treatment included antiviral drugs, prevention ofbacterialinfection and supportive treatment, and glucocorticoid and respiratory support treatment wereadministrated when necessary. Conclusions The novel coronavirus pneumonia is characterized by highly infectious, rapid progress, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve theprognosis and reduce themortality. Key words: Coronaviru infection; Pneumonia; Coronavirus disease 2019; Clinical characteristics
{"title":"Clinical features of 109 cases of novel coronavirus pneumonia","authors":"Shi Chen, Juan Wu, Zhi Ming Li, Dixiong Xu, Ziyang Zhu, Chuanhai Wang, Cheng-hong Li, P. He","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.0015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.0015","url":null,"abstract":"Objective \u0000To observe theepidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with novel coronavirus pneumonia. \u0000 \u0000 \u0000Methods \u0000Clinical data of 109 patients with suspected and definite novel coronavirus pneumonia admitted to Wuhan Sixth Hospital from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysiswas performed by using t test or chi-square test. \u0000 \u0000 \u0000Results \u0000Among the 109 patients, 48 (44%) were male and 61 (56%) were female, with the average age of (52.5±10.8) years. Fifty-four patients (49.5%) had definite contact history. Among the 109 patients, 104 (95.5%) presentedwith fever, 37(33.7%) with headache, 78 (71.9%) with general pain, 88 (80.8%) with fatigue and poor appetite, 23 (21.3%) with diarrhea, 94 (86.5%) withcoughing, 23 (21.3%) with shortness of breath, 57 (52.8%) withpalpitation, 45 (41.5%) with chest distress, 4 (3.3%) with chest pain, 40 (37.0%) with lung rales. Forty-two cases (38.5%) had leukocyte count 230 mmol/L, 29 cases (26.6%) had brain natriuretic peptide precursor>300 ng/mL, 87 cases (79.8%) had hypersensitive C-reactive protein >10mg/L, 26 cases (23.9%) had D-dimer >0.5 mg/L, 35 cases (32.1%) had coagulation disorder. The leukocyte counts, LDH, brain natriuretic peptide precursor and D-dimer of severe/critical cases[(11.33±4.87)×109/L, (527.51±260.87) mmol/L, (722.88±189.56) ng/mL, (1.89±4.24) mg/L, respectively] were all significantly higher than those of common cases [(4.02±1.49)×109/L, (159.75±30.31)mmol/L, (428.22±124.76)ng/mLand (0.41±0.22)mg/L, respectively], while the lymphocyte count of severe/critical cases [(0.60±0.17)×109/L] was significantly lower than common cases [(1.13±0.43)×109/L] (t=11.36, 11.33,9.81,2.81 and 7.77,all P<0.05). On admission, chest CT showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) werebilateral, and most of them were ground glass. The pneumonia progressed in a short time and reached the peak within 10 days. The comprehensive treatment included antiviral drugs, prevention ofbacterialinfection and supportive treatment, and glucocorticoid and respiratory support treatment wereadministrated when necessary. \u0000 \u0000 \u0000Conclusions \u0000The novel coronavirus pneumonia is characterized by highly infectious, rapid progress, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve theprognosis and reduce themortality. \u0000 \u0000 \u0000Key words: \u0000Coronaviru infection; Pneumonia; Coronavirus disease 2019; Clinical characteristics","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47412561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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