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
{"title":"2019年海南省新型冠状病毒感染症9例临床分析","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":null,"url":null,"abstract":"Objective \nTo explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). \n \n \nMethods \nThe 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. \n \n \nResults \nThere 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. \n \n \nConclusion \nAmong the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases. \n \n \nKey words: \nCoronavirus infection; Pneumonia; Coronavirus disease 2019; Critical type; Nucleic acid testing; Inflammatory cytokine","PeriodicalId":10127,"journal":{"name":"中华传染病杂志","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"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\":null,\"url\":null,\"abstract\":\"Objective \\nTo explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). \\n \\n \\nMethods \\nThe 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. \\n \\n \\nResults \\nThere 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. \\n \\n \\nConclusion \\nAmong the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases. \\n \\n \\nKey words: \\nCoronavirus infection; Pneumonia; Coronavirus disease 2019; Critical type; Nucleic acid testing; Inflammatory cytokine\",\"PeriodicalId\":10127,\"journal\":{\"name\":\"中华传染病杂志\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-04-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华传染病杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.CN311365-20200304-00208\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华传染病杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.CN311365-20200304-00208","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Clinical analysis of nine cases with critical corona virus disease 2019 in Hainan province/ 中华传染病杂志
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