COVID‐19 in a designated infectious diseases hospital outside Hubei Province, China

  1. Qingxian Cai
  2. Deliang Huang
  3. Pengcheng Ou
  4. Hong Yu
  5. Zhibin Zhu
  6. Zhang Xia
  7. Yinan Su
  8. Zhenghua Ma
  9. Yiming Zhang
  10. Zhiwei Li
  11. Qing He
  12. Lei Liu
  13. Yang Fu
  14. Jun Chen

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Abstract

Background

The clinical characteristics of novel coronavirus disease (COVID‐2019) patients outside the epicenter of Hubei Province are less understood.

Methods

We analyzed the epidemiological and clinical features of all COVID‐2019 cases in the only referral hospital in Shenzhen City, China, from January 11, 2020, to February 6, 2020, and followed until March 6, 2020.

Results

Among the 298 confirmed cases, 233 (81.5%) had been to Hubei, while 42 (14%) did not have a clear travel history. Only 218 (73.15%) cases had a fever as the initial symptom. Compared with the nonsevere cases, severe cases were associated with older age, those with underlying diseases, and higher levels of C‐reactive protein, interleukin‐6, and erythrocyte sedimentation rate. Slower clearance of the virus was associated with a higher risk of progression to critical condition. As of March 6, 2020, 268 (89.9%) patients were discharged and the overall case fatality ratio was 1.0%.

Conclusions

In a designated hospital outside Hubei Province, COVID‐2019 patients could be effectively managed by properly using the existing hospital system. Mortality may be lowered when cases are relatively mild, and there are sufficient medical resources to care and treat the disease.

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  1. ScreenIT

    SciScore for 10.1101/2020.02.17.20024018: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethics Approval: Data collection and analysis of cases and close contacts were determined by the National Health Commission of the People’s Republic of China (PRC) to be part of a continuing public health outbreak investigation and were thus considered exempt from institutional review board approval.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analyses were performed using SPSS (Statistical Package for the Social Sciences) version 22.0 software (SPSS Inc).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)

    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:
    This suggested limitations in using body temperature alone to screen the disease. Additional indications should be included in the screening criteria.The duration of fever in severe patients was much longer than mild patients (median 6[4-8] vs. 5[3-8], p<0.024), peak temperature in the severe or critical patients tends higher than mild patients but had no significant difference (p=0.063). Inflammatory responses triggered by viral infection play a crucialrole in pulmonary pathology severity.11 Our data confirmed the existence of an inflammatory factor storm; inflammatory factors increased in most of the patients, especially for CRP increased in 70% patients, IL-6 in 76.0% patients, ESR in 60.9% patients. Furthermore, compared to no-severe patients, the above three factors significant increased among severe patients (p<0.001). That suggested the three inflammatory factors may help judge the disease progression. Moreover, suppressing the hyperintense immune response to reduce lung inflammation may be a valuable treatment method, such as glucocorticoid and gamma globulin. Glucocorticoids often cause severe secondary infections; the application timing, duration and dosage need further investigation. Except for respiratory track damage, other organ damagesare of concern for the COVID-19 patients. Our data showed liver injury seldom occurred in these patients (44/298, 14.8%), and mainly in severe patients (36.2% vs. 9.6%, p<0.001). 55.4% of liver injuries occurred following administ...

    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.

  2. Version published to 10.1111/all.14309
  3. Version published to 10.1101/2020.02.17.20024018v1 on medRxiv