This study includes the basic clinical data, contact history, laboratory data, CT imaging, drug, time of nucleic acid test turning negative, time of therapy and prognosis. We found that most of these patients did not have a clear epidemiological contact history. It may be related to the increase of cases of COVID-19 infection in other areas of Hubei Province besides Wuhan. In our study ,most of the patients had a admission temperature lower than 38 ℃, which may be related to the fact that most of them were common patients. In previous studies, novel coronavirus pneumonia was mainly caused by low fever[5]. Some studies showed that elderly patients and severe patients were mainly hyperthermia[6, 7].
In this study, the CT imaging manifestations of the patients in hospital were mostly bilateral exudation. Studies have shown that novel coronavirus pneumonia is mainly manifested by bilateral exudation in CT[8]. We found that bilateral or unilateral CT findings had no effect on the prognosis. The average time of nucleic acid test turning negative is 17.37 ± 9.29 days. The average treatment time of patients is 23.74 ± 8.06 days. To explore the correlation between CT imaging, pathology and viral load is helpful to judge the imaging features of prognosis and guide clinical treatment, which needs further study. Tao AI et al. Carried out a retrospective study on 601 patients in Wuhan who were positive for RT-PCR detection of new coronavirus, and found that the average time of positive initial detection turned negative was 6.9 ± 2.3 days[9]. However, different doctors may have different standards for the first nucleic acid test of nucleic acid positive patients, which may lead to different time for nucleic acid to turn negative in different hospitals. Some cases have been reported, including some of the patients in our study who turned negative after treatment and then positive after a period of time. Therefore, the frequency and time interval of detection need to be further explored. If the detection frequency is increased or the interval is prolonged, combined with the improvement of clinical symptoms, we can more accurately estimate the progress of the disease, and further determine whether the patient carries the virus or is infectious.
The main symptoms of the patient are fever, cough, fatigue, chest tightness and gastrointestinal discomfort, which are similar to novel coronavirus pneumonia reported elsewhere[6, 7, 10]. Logistic regression analysis of the main complaints and prognosis at the time of admission showed that although the incidence of fever, cough, chest distress, fatigue and gastrointestinal discomfort were different, the first symptom had no significant effect on the prognosis of the patients.
We conducted univariate and multivariate Logistic regression analysis on the influence of laboratory data on the prognosis of patients, and found that these laboratory data had no significant influence on the prognosis of patients. It may be related to the fact that the patients we included are basically ordinary patients. Some studies have shown that the elevated ALT, AST, CRP, prothrombin time, D-dimer, urea nitrogen, creatinine in the dead patients are higher than those in the convalescent patients[11]. However, through the correlation analysis of age, temperature at admission, laboratory data and the time of nucleic acid test turning negative and treatment time, we found that age, temperature at admission, leukocyte count, neutrophil count, C-reactive protein and treatment time were positively correlated. Leukocyte count and neutrophil count were positively correlated with the time of nucleic acid test turning negative.
If we take intervention measures as early as possible after finding the pathogen, it is the most effective to suppress the outbreak of the virus. However, the new coronavirus (nCov) has unknown sensitivity to treatment, is the main source of pandemic risk. Although in such an environment, the shallow global Pharmacopoeia of generic antiviral drugs limits the clinical effectiveness of treatment from the outbreak front, it can provide the most abundant information[12]. We analyzed the drugs used in all patients during hospitalization, as shown in the Table 5, the highest use rate of interferon and arbidol, but it seems that only oseltamivir has an impact on the prognosis of patients. But whether oseltamivir can improve the prognosis of patients needs further study to confirm. Previous studies have shown the potential effect of ribavirin on nCoV[13]. Among the possible studies that should be completed are drug combinations that use the widely available abidol, interferon. The protease inhibitors lopinavir and ritonavir and oseltamivir neuraminidase are being studied. Remdesivir, which interferes with viral polymerase, can be tried[14]. Some open, multicenter RCT studies on therapeutic drugs are underway, which may provide important options for clinical treatment[15].