Clinical analysis of 379 patients of coronavirus disease 2019 (COVID-19) in Chengdu_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Zhu ¹ , MAO Yi ¹ , CHEN Ting ¹ , HU Zhaoxia ¹ , LAN Lijuan ¹ , LIU Dafeng ¹ ,  WEI Jiafu ² ,  WANG Jiachuan ³

1. Emergency Ward, Public Health Clinical Center of Chengdu, Chengdu, 610066, P.R.China;
2. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
3. Department of Infectious Diseases, The 2nd Affiliated Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital, Chengdu, 610051, P.R.China;

Corresponding author：

WEI Jiafu, Email: weijiafu@163.com; WANG Jiachuan, Email: 342661758@qq.com

Keywords：

Coronavirus disease 2019 (COVID-19); elderly; clinical features; treatment; prognosis

DOI：

10.7507/1007-4848.202101060

Video：

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Objective To analyze the clinical features and prognosis of coronavirus disease 2019 (COVID-19) patients.Methods A total of 379 confirmed COVID-19 patients admitted to Public Health Clinical Center of Chengdu from January 16 to November 30, 2020 were divided into two groups including an elderly group (42 patients, ≥60 years) and a non-elderly group (337 patients, <60 years) by age. The epidemiology, clinical features, laboratory tests, treatment and prognosis of the two groups were compared.Results Among the 379 patients, 286 (75.5%) were males and 93 (24.5%) were females, aged from 2 months to 87 years, with an average age of 41.2 years. The average age of the elderly group was 69.5 years, and 61.9% of them were females. They were imported from Wuhan or local secondary patients (73.8%), mainly common or critical type (88.1%). While, the average age of the non-elderly group was 37.8 years, and males were more common (80.1%). There were mostly from foreign input (75.7%), mainly mild or ordinary type (95.0%). A total of 179 patients (47.2%) had one or more underlying diseases. Hypertension (15 patients, 35.7%) and diabetes (11 patients, 26.2%) were more common in the elderly group, while non-alcoholic steatohepatitis (132 patients, 39.2%) was more frequent in the non-elderly group. The most common clinical manifestations were fever (138 patients, 36.4%) and cough (129 patients, 34.0%). Fever, cough, dyspnea, and fatigue were more common in the elderly group than those in the non-elderly group (P<0.05). Compared with the non-elderly group, the elderly group had lower total lymphocyte count, CD₄⁺ and CD₈⁺ T-cell count, higher level of myocardial injury or inflammation markers (P<0.05). Abnormal echocardiography in 139 patients (36.7%) was mainly caused by decreased left ventricular diastolic function (22.7%) and heart valve regurgitation (14.0%), and the rate in the elderly group was significantly higher than that in the non-elderly group (85.7% vs. 30.6%, P<0.05). After treatment, 3 patients in the elderly group died, and the others were cured and discharged. The hospitalization duration of the elderly group was longer than that of the non-elderly group (22.1 d vs. 18.8 d, P=0.033).Conclusions Elderly COVID-19 patients are mainly imported from Wuhan or secondary to the local population, mainly common or critical type, often associated with basic diseases such as hypertension or diabetes. While, non-elderly COVID-19 patients are mainly imported from abroad, mainly mild or common type, often associated with non-alcoholic steatohepatitis. After treatment, most of the patients have a good prognosis.

Citation： CHEN Zhu, MAO Yi, CHEN Ting, HU Zhaoxia, LAN Lijuan, LIU Dafeng, WEI Jiafu, WANG Jiachuan. Clinical analysis of 379 patients of coronavirus disease 2019 (COVID-19) in Chengdu. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(4): 388-395. doi: 10.7507/1007-4848.202101060 Copy

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10.	Meo SA, Alhowikan AM, Al-Khlaiwi T, et al. Novel coronavirus 2019-nCoV: Prevalence, biological and clinical characteristics comparison with SARS-CoV and MERS-CoV. Eur Rev Med Pharmacol Sci, 2020, 24(4): 2012-2019.
11.	Chen L, Liu W, Zhang Q, et al. RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia patients in 2019 Wuhan outbreak. Emerg Microbes Infect, 2020, 9(1): 313-319.
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13.	李美瑜, 吕明芳, 李翠芝, 等. 不同临床分型新型冠状病毒肺炎患者的心脏表现特征. 广东医学, 2021, 41(8): 797-800.
14.	Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus. Radiology, 2020, 295(1): 202-207.
15.	潘月影, 王玉锦, 祝婷婷, 等. 938 例老年新型冠状病毒肺炎患者影像学表现. 放射学实践, 2020, 35(3): 269-271.
16.	陈琼, 余维巍, 王丽静, 等. 老年人新型冠状病毒肺炎防治要点(试行). 中华老年医学, 2020, 39(2): 113-118.

1. Li Q, Guan X, Wu P, et al. Early transmission dynamicsin Wuhan, China, of novel coronavirus infected pneumonia. N Engl J Med, 2020, 382(13): 1199-1207.
2. 严佑琴, 郭险峰, 吴文炎, 等. 新型冠状病毒肺炎患者 496 例的临床特点和预后分析. 中华传染病杂志, 2020, 38(8): 479-482.
3. Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: A nationwide analysis. Eur Respir J, 2020, 55(5): 2000547.
4. 国家卫生健康委办公厅, 国家中医药管理局办公室. 新型冠状病毒肺炎诊疗方案(试行第八版). 中华临床感染病杂志, 2020, 13(5): 321-328.
5. 曾明全, 雷学忠, 张敏利, 等. 四川省 20 例重症新型冠状病毒肺炎的流行病学和临床特征分析. 华西医学, 2020, 35(4): 377-384.
6. Guisado-Vasco P, Valderas-Ortega S, MM Carralon-Gonzalez, et al. Clinical characteristics and outcomes among hospitalized adults withsevere COVID-19 admitted to a tertiary medical center and receivingantiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort). E Clinical Medicine, 2020, 28: 100591.
7. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus infected pneumonia in Wuhan, China. JAMA, 2020, 323(11): 1061-1069.
8. Heng BSL, Chidambaram SK, Ci WX, et al. Clinical characteristics and risk factors for severe COVID-19 infections in Malaysia: A nationwide observational study. Lancet Regional Health-Western Pacific, 2020: 100055.
9. Sun P, Qie S, Liu Z, et al. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta analysis. J Med Virol, 2020, 92(6): 612-617.
10. Meo SA, Alhowikan AM, Al-Khlaiwi T, et al. Novel coronavirus 2019-nCoV: Prevalence, biological and clinical characteristics comparison with SARS-CoV and MERS-CoV. Eur Rev Med Pharmacol Sci, 2020, 24(4): 2012-2019.
11. Chen L, Liu W, Zhang Q, et al. RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia patients in 2019 Wuhan outbreak. Emerg Microbes Infect, 2020, 9(1): 313-319.
12. Lu R, Zhao X, Li J, et al. Genomic characterization and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet, 2020, 395(10224): 565-574.
13. 李美瑜, 吕明芳, 李翠芝, 等. 不同临床分型新型冠状病毒肺炎患者的心脏表现特征. 广东医学, 2021, 41(8): 797-800.
14. Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus. Radiology, 2020, 295(1): 202-207.
15. 潘月影, 王玉锦, 祝婷婷, 等. 938 例老年新型冠状病毒肺炎患者影像学表现. 放射学实践, 2020, 35(3): 269-271.
16. 陈琼, 余维巍, 王丽静, 等. 老年人新型冠状病毒肺炎防治要点(试行). 中华老年医学, 2020, 39(2): 113-118.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of 379 patients of coronavirus disease 2019 (COVID-19) in Chengdu

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