Comparison of clinical characteristics of 94 patients with common and severe or critical COVID-19 in Wuhan

Abstract:

Objective：To analyze the clinical characteristics of severe and critical coronavirus disease 2019（COVID-19） confirmed patients，and provide clinical evidences for early identification and intervention. Methods：The clinical data of discharged patients with confirmed COVID-19 at Wuhan Red Cross Hospital from January 24 to March 10，2020 were retrospectively analyzed. According to the severity of the disease，they were divided into the general group，and the severe or critical group. The demographic characteris－tics，clinical characteristics，treatments，and outcomes were compared between the two groups. Results：A total of 94 patients with confirmed COVID-19 were selected，including 46 males and 48 females，with a median age of 54 years old. There were 25 patients in severe or critical group and 69 patients in general group. Totally，there were 56 cured，32 improved and 6 dead patients. Hypertension，diabetes，and coronary heart disease were the most common co－morbidities；cough，fever，and fatigue were the main clinical manifestations and ground-glass was the feature of imaging ex－amination in both groups. Compared with general patients，severe and critical patients had the following characteristics：they were older and had much more frequencies in fever，dry cough and dyspnea；they had lower lymphocyte count[（0.80±0.11）×109/L vs. （1.34±0.10）×109/L，P<0.001] and ratio[（15.510±1.913）% vs. （25.590±1.503）%，P<0.001]，albumin[33.85（28.28-38.33） g/L vs. 38.70（36.03-41.43） g/L，P=0.003]，higher neutrophil ratio[74.70（64.65-88.40）% vs. 62.25（53.53-72.60）%，P=0.002] and C-reac－tive protein[65.15（11.23-123.49） mg/L vs. 4.51（1.54-15.39） mg/L，P<0.001] level. Moreover，the majority severe and critical patients showed bilateral pneumonia according to imaging examination. In terms of treatment，severe and critical patients had higher rates of using 3 or more antiviral and anti-inflammatory drugs，however，the cure rate was lower with higher mortality rate. Furthermore，the proportion of using traditional Chinese medicine in cured patients was higher than that of dead patients[23（41.07） vs. 1（16.67），P=0.082]. Conclusion：Compared to the general COVID-19 patients，severe and critical COVID-19 patients had higher mortality，were older with bilateral pneumonia，and had more frequencies of fever，dry cough，and dyspnea. Blood laboratory tests had shown lower level of albumin and absolute counts and ratio of lymphocytes. On the contrary，CRP and blood neutrophil ratio were higher. Up to now，there have had no promising therapy to treat COVID-19，the clinical efficacy of traditional Chinese medicine needs to be fur－ther confirmed by larger sample design and rigorous clinical studies.