As of February 15, 2020, 81 patients diagnosed with 2019-nCoV pneumonia at Hankou Hospital were included in the study. All of them were residents of Wuhan City, including the 38 medical staff members infected by patients while working. Among the 38 medical staff members, 31 were from Hankou Hospital and 7 were transferred from other hospitals. Forty-three non-medical individuals did not have a clear history of direct exposure to the Huanan Seafood Market, but 2 (2.5%) had been exposed to confirmed or highly suspected 2019-nCoV infections. The median age of all patients was 49 years (IQR, 35–59; range, 23–89 years), and 42 (51.9%) were women. There were no children or adolescents among the included patients. The median time from onset to hospital admission or medication was 5 days (IQR, 3–9). Almost all patients were admitted one day after their chest CT results came back positive, and they began receiving medication once admitted. Among the included patients, 38 (46.9%) had chronic diseases, including hypertension (16 [19.8%]), diabetes (6 [7.4%]), coronary heart disease (7 [8.6%]), tumor (3 [3.7%]), chronic obstructive pulmonary disease (3 [3.7%]), and other chronic diseases (25 [30.9%]) such as chronic gastritis, hypothyroidism, sequelae of cerebral infarction, and myasthenia gravis. The results of all pharynx swabs for influenza A and B were negative. The most common symptoms at onset were fever (85.2%), cough (54.3%), and fatigue (33.3%). Other symptoms included dyspnea (14.8%), sore throat (6.2%), headache (4.9%), and diarrhea (4.9%). All patients were diagnosed with unilateral or bilateral typical changes in a chest CT, including patch and cloud-like infiltration shadows or ground glass opacity. In the routine blood test performed upon admission, the leucocyte count was lower than normal in 23 (28.4%) patients, and the leukomonocyte count was lower than normal in 48 (59.3%). The platelet count was lower than normal in 14 (17.3%) cases, while the C-reactive protein level was higher than normal in 52 (67.9%). The median C-reactive protein level was 16.12 mg/L (IQR, 6.1–42.8 mg/L; Normal 0–6 mg/L), and the median procalcitonin level was 0.062 ng/ml (IQR, 0.042–0.118; Normal 0-0.05 ng/ml), reflecting the inflammatory state of the body (Table 1 and Fig. 1). Twenty-four of the 81 patients were admitted to intensive care units (ICU); of these, 13 died and 11 were cured. The ICU mortality rate was 54%. Organ function impairment occurred in a small number of patients, including 14 (17.2%) patients with acute respiratory distress syndrome, 2 (2.5%) patients with acute kidney injury, 9 (11.1%) patients with heart injury, and 22 (27.2%) patients with abnormal liver function. In all, 77 (95%) patients received antiviral therapy, including oseltamivir (76.5%), ritonavir (27.2%), lopinavir/ritonavir (23.5%), umifenovir (7.4%), and ribavirin (2.4%). Eighty (98.8%) patients accepted antimicrobials, including moxifloxacin, cefoperazone sodium and sulbactam sodium, azithromycin, and cephalosporin. Fifty-three (65.4%) patients accepted glucocorticoid, and 72 (88.9%) accepted immunoglobulin. Thirty-six (44.4%) patients received oxygen support due to hypoxemia.
Table 1
Demographics, baseline characteristics, symptoms, comorbidities, laboratory examination and treatments of patients with 2019-nCoV pneumonia. Data are median (IQR), n (%), or n/N (%), where N is the total number of patients with available data. p values comparing survivors and non-survivors are from χ² test, Fisher’s exact test, or Mann-Whitney U test. 2019-nCoV = 2019 novel coronavirus.
| Total(n = 81) | survivors(n = 68) | Non-survivors(n = 13) | P value |
Age(median [IQR] y) | 49(35–59) | 42(33–54) | 69(60–79) | < 0.001 |
Sex | 。。。 | 。。。 | 。。。 | 0.292 |
Male | 39(48.1%) | 31(45.6%) | 8(61.5%) | 。。。 |
female | 42(51.9%) | 37(54.4%) | 5(38.5%) | 。。。 |
Time from onset to CT positive (median [IQR], d) | 4(2–8) | 4(2–9) | 5(2–6) | 0.430 |
Time from onset to admission (median [IQR], d) | 5(3–9) | 5(3–10) | 6(3–7) | 0.430 |
Time from onset to medication (median [IQR], d) | 5(3–9) | 5(3–10) | 6(3–7) | 0.430 |
Comorbidity | 38(46.9%) | 27(39.7%) | 11(84.6%) | 0.003 |
Hypertension | 16(19.8%) | 10(14.7%) | 6(46.2%) | 0.018 |
Diabetes | 6(7.4%) | 2(2.9%) | 4(30.8%) | 0.005 |
Coronary heart disease | 7(8.6%) | 2(2.9%) | 5(38.5%) | 0.001 |
Tumor | 3(3.7%) | 3(4.4%) | 0(0%) | 1.000 |
COPD | 3(3.7%) | 1(1.5%) | 2(15.4%) | 0.066 |
Other | 25(30.9%) | 18(26.5%) | 7(53.8%) | 0.097 |
Fever(≥37.3℃) | 69(85.2%) | 56(82.4%) | 13(100%) | 0.198 |
Cough | 44(54.3%) | 38(55.9%) | 6(46.2%) | 0.519 |
Fatigue | 27(33.3%) | 24(35.3%) | 3(23.1%) | 0.528 |
Dyspnea | 12(14.8%) | 9(13.2%) | 3(23.1%) | 0.398 |
Headache | 4(4.9%) | 4(5.9%) | 0(0%) | 1.000 |
Sore throat | 5(6.2%) | 5(7.4%) | 0(0%) | 0.587 |
Diarrhea | 4(4.9%) | 3(4.4%) | 1(7.7%) | 0.511 |
Blood routine (median [IQR]) |
White blood cell, 109/L (Normal 3.5–9.5*109/L) | 4.3(3.3–5.8) | 4.3(3.2–5.3) | 5.8(4.3–7.5) | 0.063 |
< 3.5 | 23(28.4%) | 20(29.4%) | 3(23.1%) | 0.749 |
3.5–9.5 | 55(67.9%) | 46(67.6%) | 9(69.2%) | 1.000 |
> 9.5 | 3(3.7%) | 2(2.9%) | 1(7.7%) | 0.413 |
Leukomonocyte count, 109/L (Normal 1.1–3.2*109/L) | 0.9(0.6–1.3) | 1(0.7–1.4) | 0.5(0.3–0.8) | 0.001 |
< 1.1 | 48(59.3%) | 36(52.9%) | 12(92.3%) | 0.008 |
Neutrophile count, 109/L (Normal 1.8–6.3*109/L) | 3.1(2–4) | 3(1.9–3.7) | 4.7(3.1–6.5) | 0.003 |
Platelet count, 109/L (Normal 125–350*109/L) | 170.5(138.8-233.5) | 180(144.5–242) | 134(118–150) | 0.006 |
< 125 | 14(17.3%) | 9(13.2%) | 5(38.5%) | 0.043 |
C reactive protein, mg/L (Normal 0–6 mg/L) | 16.12(6.1–42.8) | 13.7(5.6–35.3) | 116.7(91.6-126.6) | 0.003 |
> 6 | 52(67.9%) | 44(64.7%) | 8(61.5%) | 1.000 |
Coagulation function (median [ IQR]) |
D-dimer (Normal 0-0.5ug/ml) | 0.15(0.04–0.39) | 0.12(0.02–0.34) | 0.25(0.22–6.2) | 0.026 |
> 0.5 | 13(16%) | 10(14.7%) | 3(23.1%) | 0.429 |
Blood biochemistry (median [IQR]) |
urea nitrogen, mmol/L (Normal 3.2–7.1 mmol/L) | 4(3.2–5.2) | 3.9(3.0-5.1) | 5.2(4.8–7.4) | 0.001 |
ALT, IU/L (Normal 0–40 IU/L) | 21(15.8–33) | 21(12–33) | 23(20–31) | 0.306 |
> 40 | 17(21%) | 14(20.6%) | 3(23.1%) | 1.000 |
AST, IU/L (Normal 0–40 IU/L) | 28(21–42) | 25(18.5–34) | 42(39–59) | 0.001 |
> 40 | 22(27.2%) | 13(19.1%) | 9(69.2%) | 0.001 |
Total protein, g/L (Normal 60–80 g/L) | 67.8(61.5–71.3) | 68.2(63.3–71.7) | 61.6(57–68) | 0.056 |
< 60 | 14(17.3%) | 10(14.7%) | 4(30.8%) | 0.224 |
Albumin, g/L (Normal 34–54 g/L) | 37.7(33.5–40.7) | 38.6(34.9–41) | 31.4(30.1–35.9) | 0.001 |
< 34 | 22(27.2%) | 14(20.6%) | 8(61.5%) | 0.005 |
Creatinine, mmol/L (Normal 50–120 mmol/L) | 64(53–78) | 64(51.5–77.3) | 66(57–80) | 0.239 |
LDH, IU/L (Normal 120–250 IU/L) | 216(174.5–349) | 197(164.8–260) | 463(369–685) | < 0.001 |
> 250 | 30(37%) | 18(26.5%) | 12(92.3%) | < 0.001 |
K, mmol/L (Normal 3.5–5.5 mmol/L) | 4(3.6–4.3) | 4(3.6–4.3) | 3.9(3.6–4.1) | 0.531 |
Na, mmol/L (Normal 135–145 mmol/L) | 140(138–142) | 141(139–142) | 135(134–136) | < 0.001 |
Other indicators (median [IQR]) |
NT-proBNP, pg/ml (Normal 0-125 pg/ml) | 93.3(33-271.3) | 48.9(29.6-158.3) | 290.6(161.8-727.8) | < 0.001 |
cTnI (positive) | 9(11.1%) | 3(4.4%) | 6(46.2%) | < 0.001 |
PCT, ng/ml (Normal 0-0.05 ng/ml) | 0.062(0.042–0.118) | 0.058(0.038–0.083) | 0.211(0.102–0.358) | < 0.001 |
> 0.05 | 47(58%) | 34(50%) | 13(100%) | 0.001 |
Drug treatment | | | | |
Glucocorticoid | 53(65.4%) | 41(60.3%) | 12(92.3%) | 0.028 |
Immunoglobulin | 72(88.9%) | 59(86.8%) | 13(100%) | 0.342 |
Antiviral drugs | | | | |
oseltamivir | 62(76.5%) | 50(73.5%) | 12(92.3%) | 0.281 |
ritonavir | 22(27.2%) | 16(23.5%) | 6(46.2%) | 0.170 |
lopinavir/ritonavir | 19(23.5%) | 19(27.9%) | 0(0%) | 0.032 |
umifenovir | 6(7.4%) | 6(8.8%) | 0(0%) | 0.582 |
ribavirin | 2(2.4%) | 2(2.9%) | 0(0%) | 1.000 |
We found that the non-survivors were older than survivors. The incidence of chronic diseases, especially hypertension, diabetes, and coronary heart disease, was also higher among non-survivors. The results showed that the median age of the 13 deceased patients was 69 years (IQR, 60–79 years); of these 11 (84.6%) were older than 60 years, and the majority was male (61.5%). In contrast, the median age of survivors was 42 years (IQR, 33–54 years). There were also several differences in the laboratory findings between survivors and non-survivors. The median lymphocyte count of survivors was 1*109/L (IQR, 0.7–1.4*109/L), while the median lymphocyte count of non-survivors was 0.5*109/L (IQR, 0.3–0.8*109/L). The lymphocyte count was lower than normal in 36 (52.9%) survivors and in 12 (92.3%) non-survivors (Table 1 and Fig. 2). The median urea nitrogen level was lower in survivors than non-survivors (3.9 mmol/L [IQR, 3.0-5.1 mmol/L] vs. 5.2 mmol/L [IQR, 4.8–7.4 mmol/L], respectively). The aspartate aminotransferase level was lower in survivors than non-survivors (25 IU/L [IQR, 18.5–34 IU/L] vs. 42 IU/L [IQR, 39–59 IU/L], respectively). The lactate dehydrogenase level was lower in survivors than non-survivors (197 IU/L [IQR, 164.8–260 IU/L] vs. 463 IU/L [IQR, 369–685 IU/L], respectively) (Table 1 and Fig. 3). Most patients in both groups received antibacterial (moxifloxacin, cefoperazone sodium and sulbactam sodium, azithromycin, and cephalosporin) and antiviral therapy (oseltamivir, ritonavir, lopinavir/ritonavir, and umifenovir); only the p-value for lopinavir/ritonavir differed. Moreover, intravenous immunoglobulin was used in most patients (88.9%) (all data shown in Table 1).
Our results revealed significant differences between medical staff members and non-medical individuals in the time from onset to admission(Figure 4), comorbidity, disease classification, and prognosis. The median time for medical staff members from onset to admission or medication was 3.5 days (IQR, 2–5 days), while that for non-medical individuals was 7 days (IQR, 4.5–10 days). Moreover, medical staff members had fewer comorbidities. Most medical staff members (86.8%) were diagnosed with common pneumonia, while most non-medical individuals (41.9%) were diagnosed with critical pneumonia. All of the medical staff members were cured, while 13 (30.2%) of the non-medical individuals died (all the data is in Table 2).
Table 2
Time from onset to admission, disease classification, and prognosis of patients with 2019-nCoV pneumonia. Data are median (IQR), n (%), or n/N (%), where N is the total number of patients with available data. p values comparing medical staff and non-medical staff are from χ² test, Fisher’s exact test, or Mann-Whitney U test.
| Total(n = 81) | Medical staff(n = 38) | Non-medical staff(n = 43) | P value |
Age(median [IQR], y) | 49(35–59) | 36(30–43) | 57(51–71) | < 0.001 |
Sex | 。。。 | 。。。 | 。。。 | 0.142 |
Male | 39(48.1%) | 15(39.5%) | 24(55.8%) | 。。。 |
Female | 42(51.9%) | 23(60.5%) | 19(44.2%) | 。。。 |
Time from onset to CT positive (median [IQR], d) | 4(2–8) | 2.5(1–4) | 6(3.5-9) | < 0.001 |
Time from onset to admission (median [IQR], d) | 5(3–9) | 3.5(2–5) | 7(4.5–10) | < 0.001 |
Time from onset to medication (median [IQR], d) | 5(3–9) | 3.5(2–5) | 7(4.5–10) | < 0.001 |
Comorbidity | 38(46.9%) | 12(31.6%) | 26(60.5%) | 0.009 |
hypertension | 16(19.8%) | 1(2.6%) | 15(34.9%) | < 0.001 |
diabetes | 6(7.4%) | 0(0%) | 6(14%) | 0.027 |
Coronary heart disease | 7(8.6%) | 0(0%) | 7(16.3%) | 0.013 |
Tumor | 3(3.7%) | 0(0%) | 3(7%) | 0.244 |
COPD | 3(3.7%) | 0(0%) | 3(7%) | 0.244 |
Other | 25(30.9%) | 11(28.9%) | 14(32.6%) | 0.726 |
Classification | | | | |
Commom | 45(55.6%) | 33(86.8%) | 12(27.9%) | < 0.001 |
Severe | 17(21%) | 4(44.7%) | 13(30.2%) | < 0.001 |
Critical | 19(23.4%) | 1(2.6%) | 18(41.9%) | < 0.001 |
Prognosis | | | | |
Cured | 63(77.8%) | 38(100%) | 25(58.1%) | < 0.001 |
Die | 13(16%) | 0(0%) | 13(30.2%) | < 0.001 |
In hospital | 5(6.2%) | 0(0%) | 5(11.6%) | < 0.001 |