Clinical features and management of severe COVID-19: A retrospective study in Wuxi, Jiangsu Province, China

  1. Xiufeng Jiang
  2. Jianxin Tao
  3. Hui Wu
  4. Yixin Wang
  5. Wei Zhao
  6. Min Zhou
  7. Jiehui Huang
  8. Qian You
  9. Meng Hua
  10. Feng Zhu
  11. Xiaoqing Zhang
  12. Meifang Qian
  13. Yuanwang Qiu

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Abstract

Objective

We aimed to investigate clinical features and management of 55 COVID-19 patients in Wuxi, especially severe COVID-19.

Methods

Epidemiological, demographic, clinical, laboratory, imaging, treatment, and outcome data of patients were collected. Follow-up lasted until April 6, 2020.

Results

All 55 patients included 47 (85.5%) non-severe patients and 8 (14.5%) severe patients. Common comorbidities were hypertension and diabetes. Common symptoms were fever, cough and sputum. Lymphopenia was a common laboratory finding, and ground-glass opacity was a common chest CT feature. All patients received antiviral therapy of α-interferon inhalation and lopinavir-ritonavir tablets. Common complications included acute liver injury and respiratory failure. All patients were discharged. No death was occurred and no medical staff got infected. Patients with severe COVID-19 showed significantly older age, decreased lymphocytes, increased C reactive protein, and higher frequency of bilateral lung infiltration compared to non-severe patients. Significantly more treatments including antibiotic therapy and mechanical ventilation, longer hospitalization stay and higher cost were shown on severe patients.

Conclusions

Our study suggested that patients with severe COVID-19 may be more likely to have an older age, present with lymphopenia and bilateral lung infiltration, receive multiple treatments and stay longer in hospital.

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  1. ScreenIT

    SciScore for 10.1101/2020.04.10.20060335: (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 Commission of Wuxi Fifth People’s Hospital (2020-007-1), a designated infectious diseases hospital of COVID-19 and informed consent from participants was also waived by the Ethics Commission.
    Consent: This study was approved by the Ethics Commission of Wuxi Fifth People’s Hospital (2020-007-1), a designated infectious diseases hospital of COVID-19 and informed consent from participants was also waived by the Ethics Commission.
    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 SPSS (version 26.0) or Graphpad Prism (version 8.0).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    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:
    Several limitations do exist in our study. First, this study included only 55 cases thanks to good monitoring and screening in Wuxi, which may cause some statistical and selective bias of our results. Second, no immune function test like serum T cells or cytokines and some other tests like serum lactate dehydrogenase were involved in the laboratory test. As such their role might be underestimated in causing severe disease. Third, this study was limited to the local investigation, and the findings may be inconsistent with nationwide or worldwide studies, which may decrease its credibility.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04257656TerminatedA Trial of Remdesivir in Adults With Severe COVID-19
    NCT04252664SuspendedA Trial of Remdesivir in Adults With Mild and Moderate COVID…
    NCT04292899CompletedStudy to Evaluate the Safety and Antiviral Activity of Remde…

    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.

  2. Version published to 10.1101/2020.04.10.20060335v1 on medRxiv