Clinical characteristics and outcomes of 2019-nCoV-infected patients admitted at different time periods

W.-R. Liu, G.-J. Zuo, Y. Qin

Department of Pathology, Yangtze University Health Science Center, Jingzhou, Hubei, P.R. China. iiamyk@sina.com

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• Infectious Diseases

OBJECTIVE: The outbreak of the 2019 Novel Coronavirus Disease (COVID-19) is seriously threatening the health of people all over China and the world. This study aims to investigate the clinical characteristics and outcomes of COVID-19 patients admitted at different time periods.

PATIENTS AND METHODS: A total of 132 discharged cases and 10 deaths of laboratory or clinically confirmed cases were retrospectively collected from The First People’s Hospital of Jingzhou, Hubei. All cases were divided into two groups according to different admission times (group 1 from 2020-1-23 to 2020-2-3 and group 2 from 2020-2-4 to 2020-2-15). Individual data, clinical data, laboratory indices and prognosis were collected for the two groups, and statistical analysis was performed using the t-test or chi-square test to assess differences between the groups.

RESULTS: Among the 142 cases, there were 67 in the first group and 75 in the second group. According to the individual data and clinical manifestations of the two groups, the hospital stay in the first group was significantly longer than that of the second group (26 [9-39] compared with 20 [6-30], p=0.000). There were more clinical symptoms upon admission in group 1 than in group 2; although 66.2% of all patients had fever, the proportion of patients with fever on admission in the first group was significantly higher than that in the second group (79.1% compared with 54.7%, p=0.002). The proportion of patients with chills in the first group was higher than that in the second group (16.4% compared with 5.3%, p=0.032), and the proportion of patients with dyspnea was also higher than that in the second group (17.9% compared with 4%, p=0.007). Four of the 67 patients in the first group had symptoms of ocular discomfort, but none in the second group had this symptom (6.0% compared with 0, p=0.032). Based on laboratory examination, the inflammatory index of patients in the first group was higher than that in the second group, and the proportion of patients with a C-reactive protein (CRP) increase was also significantly higher (60% compared with 38.7%, p=0.020). The main difference in routine blood tests involved white blood cell and lymphocyte counts and the lymphocyte percentage. The proportion of patients with reduced white blood cell counts in the first group was higher than that in the second group (23.9% compared with 10.7% p=0.036). Moreover, more patients in the first group had a reduced lymphocyte count and percentage (71.6% compared with 30.7% p=0.000; 49.3% compared with 29.7% p=0.015, respectively), and the former was significantly lower than that in the second group (0.94 [0.24-2.42] compared with 1.365 [0.22-3.62], p=0.000). Regarding prognosis, the proportion of severe cases and mortality in the first group were slightly higher than in the second group (p>0.05).

CONCLUSIONS: The clinical manifestations, blood changes and outcomes differed in patients admitted at different time periods. In the second group of patients, clinical symptoms were less common than in the first group, routine blood changes and inflammatory indices were milder, and the clinical prognosis was better.

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