Till now, there is no specific drugs for COVID–19 but the general supportive therapy and treatment in isolation. For mild patients, it usually clears spontaneously, nevertheless severe illnesses develop to acute respiratory distress syndrome (ARDS), multiple system organ failure or even death easily. In this study, more men than women and more older than the younger in critically ill patients, and the median (range) age of the 19 patients was 73 (38–91) years. There are 8(42.1%)patients had died, and the median duration from ICU to death was 2 (IQR: 1–10.75) days in non-survivors. These results suggest that Sex, age are affecting the risk factors. Patients with a history of basic disease (High blood pressure or diabetes) are at increased risk of becoming critically ill or dying if they have COVID–19 infection. These findings are consistent with previous reports [Chen N et al. 2020; Huang et al. 2020]. Population susceptibility to infection by the new virus drives the dynamics of an pandemic. Their clinical manifestations include fever, fatigue and dry cough without phlegm, a few patients with nasal congestion, runny nose, sore throat and diarrhea [Cui et al.2019; Zhu et al.2020]. Critically ill patients were more vulnerable to dyspnea, hypoxaemia even the ARDS, irreformable metabolic acidosis,sepsis and coagulation disturbance after one Week [Wang et al. 2020]. Our study found that the severe patients go to the hospital almost only at the first symptoms of fever and cough, and from the symptoms began util to ICU admission time is 6.4 d, and there 18 cases (94.7%) develop to ARDS rapidly.
As for laboratory tests, 19 cases (100%)showed ground-glass changes on chest CT. The vast majority of these Clinical lab index have changed significantly, the hs-CRP and SAA were increased obviously of 19 cases (100%); 9 cases (47%) deviant in cardiac muscle enzymes and troponin T. 12 cases (63%) liver function; 11 cases (58%) were deviant in fibrinogen (FIB) and D-dimer, In particular, the increase in D-dimer was significantly higher in the non-survivors patients (n = 8, 100%) than in the survivors patients (n = 11, 27%). It suggested that D-dimer can be used to monitor the change of the condition in severe patients (Figure 1);; There are 16(84.2%)cases which the total number of lymphocytes decreased which may prompt that COVID–19 infects cells of the human immune system, destroying or impairing their function.
Previous studies showed that the virus can induce the body to produce oxidative stress and release a large amount of active oxygen free radicals which can one hand make the virus replication enhance unceasingly, on the other hand, the excessive free radicals can damage the body’s biological membrane lipid peroxidation, enzyme, amino acid and the oxidative protein, last to injury the organs, such as lung, heart, liver, kidney, etc [Honce et al. 2019; Li et al. 2020; Zhu et al. 2019;].
COVID–19 belongs to the viru which easily to be a mistake in process of RNA replication as this result, we suspect that the new coronavirus in patients with multiple organ function damage most likely related to this. Imaging aspects: 19 cases (100%)showed ground-glass changes on chest CT which to evaluate the imaging signs in making its early diagnosis.
In conclusion, to analyze the clinical features of patients with Corona Virus Disease 2019 (COVID–19), we foud that Sex, age are affecting the risk factors. Patients with a history of basic disease (High blood pressure or diabetes) are at increased risk of becoming critically ill or dying if they have COVID–19 infection. Chest computed tomography (CT), lymphocyte count, hs-CRP and SAA can be used in disease diagnosis. D-dime plays an important role in critically ill patients and it suggested that D-dimer can be used to monitor the change of the condition in severe patients. There is a certain limitation as the less sample of this study and it belongs to the retrospective study. We hope have more samples, a more comprehensive study to bring better means for the clinical treatment of COVID–19.