Clin Infect Dis. 2020 Mar 16. pii: ciaa270. doi: 10.1093/cid/ciaa270. [Epub ahead of print]
Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Mo P1, Xing Y2, Xiao Y2, Deng L1, Zhao Q3, Wang H3, Xiong Y1, Cheng Z4, Gao S1, Liang K1, Luo M1, Chen T1, Song S1, Ma Z1, Chen X1, Zheng R1, Cao Q1, Wang F3, Zhang Y1. Abstract
BACKGROUND:
Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. This study aimed to clarify the characteristics of patients with refractory COVID-19.
METHODS:
In this retrospective single-center study, we included 155 consecutive patients with confirmed COVID-19 in Zhongnan Hospital of Wuhan University from January 1st to February 5th. The cases were divided into general and refractory COVID-19 groups according to the clinical efficacy after hospitalization, and the difference between groups were compared.
RESULTS:
Compared with general COVID-19 patients (45.2%), refractory patients had an older age, male sex, more underlying comorbidities, lower incidence of fever, higher levels of maximum temperature among fever cases, higher incidence of breath shortness and anorexia, severer disease assessment on admission, high levels of neutrophil, aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein, lower levels of platelets and albumin, and higher incidence of bilateral pneumonia and pleural effusion (P<0 .05="" nbsp="" p="">Refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorant, and adjunctive treatment including corticosteroid, antiviral drugs and immune enhancer (P<0 .05="" adjustment="" after="" class="highlight" refractory="" span="" those="" with="">COVID-19
Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. This study aimed to clarify the characteristics of patients with refractory COVID-19.
METHODS:
In this retrospective single-center study, we included 155 consecutive patients with confirmed COVID-19 in Zhongnan Hospital of Wuhan University from January 1st to February 5th. The cases were divided into general and refractory COVID-19 groups according to the clinical efficacy after hospitalization, and the difference between groups were compared.
RESULTS:
Compared with general COVID-19 patients (45.2%), refractory patients had an older age, male sex, more underlying comorbidities, lower incidence of fever, higher levels of maximum temperature among fever cases, higher incidence of breath shortness and anorexia, severer disease assessment on admission, high levels of neutrophil, aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein, lower levels of platelets and albumin, and higher incidence of bilateral pneumonia and pleural effusion (P<0 .05="" nbsp="" p="">Refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorant, and adjunctive treatment including corticosteroid, antiviral drugs and immune enhancer (P<0 .05="" adjustment="" after="" class="highlight" refractory="" span="" those="" with="">COVID-19
Nearly 50% COVID-19 patients could not reach obvious clinical and radiological remission within 10 days after hospitalization. The patients with male sex, anorexia and no fever on admission predicted poor efficacy.
©
The Author(s) 2020. Published by Oxford University Press for the
Infectious Diseases Society of America. All rights reserved. For
permissions, e-mail: journals.permissions@oup.com. KEYWORDS:
COVID-19; SARS-CoV-2; clinical efficacy; predictors
- PMID:
- 32173725
- DOI:
- 10.1093/cid/ciaa270
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