Epidemiological and clinical characteristics of discharged patients infected with SARS‐CoV‐2 on the Qinghai Plateau

  1. Aiqi Xi
  2. Ma Zhuo
  3. Jingtao Dai
  4. Yuehe Ding
  5. Xiuzhen Ma
  6. Xiaoli Ma
  7. Xiaoyi Wang
  8. Lianmeng Shi
  9. Huanying Bai
  10. Hongying Zheng
  11. Eric Nuermberger
  12. Jian Xu

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Abstract

Since the outbreak of coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) was first reported in Wuhan, a series of confirmed cases of COVID‐19 were found on the Qinghai‐Tibet plateau. We aimed to describe the epidemiological, clinical characteristics, and outcomes of all confirmed cases in Qinghai, a province at high altitude. The region had no sustained local transmission. Of all 18 patients with confirmed SARS‐CoV‐2 infection, 15 patients comprising four transmission clusters were identified. Three patients were infected by direct contact without travel history to Wuhan. Of 18 patients, 10 patients showed bilateral pneumonia and two patients showed no abnormalities. Three patients with comorbidities such as hypertension, liver diseases, or diabetes developed severe illness. High C‐reactive protein levels and elevations of both alanine aminotransferase and aspartate aminotransferase were observed in three severely ill patients on admission. All 18 patients were eventually discharged, including the three severe patients who recovered after treatment with noninvasive mechanical ventilation, convalescent plasma, and other therapies. Our findings confirmed human‐to‐human transmission of SARS‐CoV‐2 in clusters. Patients with comorbidities are more likely to develop severe illness.

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  1. Version published to 10.1002/jmv.26032
  2. ScreenIT

    SciScore for 10.1101/2020.04.23.20077644: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the ethics commissions of the two hospitals.
    Consent: The requirement for informed patient consent was waived by the ethics committees for this retrospective study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were done using the Graphpad Prism software, version 8.02, unless otherwise indicated.
    Graphpad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has several limitations. First, with the limited number of cases in Qinghai province, the results should be interpreted with caution. Second, we did not investigate the correlation between the viral load and the dynamics of cellular immune responses, which may be related to the severity of COVID-19. Third, at the time of convalescent plasma transfusion, the antibody level test (IgG, IgM et al) had not yet been routinely introduced at the hospital and no treatment guideline for using convalescent plasma was released. We did not measure the antibody concentrations in severe patients before and after convalescent plasma transfusion, so it is difficult to accurately evaluate the efficacy related to convalescent plasma. In summary, all 18 patients with COVID-19 were discharged after treatment. Immunotherapy including convalescent plasma could be beneficial for severe patients. The strategies of early detection, early diagnosis, early isolation, and early treatment of COVID-19 in Qinghai are of importance to prevent the transmission and improve the cure rate.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.04.23.20077644 on medRxiv