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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsLancet: Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Published:January 24, 2020
Summary
Background
A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients.
Methods
All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.
Findings
By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·058·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·013·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα.
Interpretation
The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies.
Background
A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients.
Methods
All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.
Findings
By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·058·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·013·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα.
Interpretation
The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies.
haemoptysis = the coughing up of blood
Dyspnoea = difficult or labored breathing
lymphopenia = reduced level of a certain type of blood cell called a lymphocyte. Lymphocytes are one of three types of white blood cells
This is the first major article about brand new findings. It's very long and highly, highly technical.
If you can, try to highlight the entire address link below and open it in a new window. (I'm really having trouble posting this paper, as if Lancet really doesn't want it posted. Anybody know why when I cut and paste this link it either doesn't work or pastes as a broken link?)
LINK: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30183-5.pdf
Another "through twitter" link to the Lancet piece. (THIS one is working better).
Link to tweet
Maybe DUers with expertise in this area might read and point out what they find of significance.
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Lancet: Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China (Original Post)
Mike 03
Jan 2020
OP
Thanks, that's good info. Here's a link to another article from The CBC/Canada covering the same
abqtommy
Jan 2020
#2
Mike 03
(16,616 posts)1. This is interesting: one case of an infected child with no outward symptoms
abqtommy
(14,118 posts)2. Thanks, that's good info. Here's a link to another article from The CBC/Canada covering the same
topic (this was on the CBC website at 5 am this morning):
https://www.cbc.ca/news/health/novel-coronavirus-symptoms-1.5438137
"The new coronavirus: Symptoms, prevention, and what to do if you think you're infected
Social Sharing
If you have travelled to Wuhan, China, follow up with a health-care professional."
more at link
Mike 03
(16,616 posts)3. Thank you for posting this. nt
abqtommy
(14,118 posts)5. You're welcome. This new coronavirus is a big concern here amongst my family. It could turn
out to be as big a disaster as tRUMP, if that's possible...
Mike 03
(16,616 posts)6. My best wishes to your family. I hope they are safe
and stay healthy.
abqtommy
(14,118 posts)7. Thanks, I hope we're ALL safe!
Mike 03
(16,616 posts)9. Definitely.
cwydro
(51,308 posts)4. Interesting that men are the ones with the most infection.
Maybe because they had connections to that market in some way?
Mike 03
(16,616 posts)8. Maybe so. It's also interesting that the majority of patients had no underlying
illness. With a lot of infections you hear that they attack people who are compromised in some way.
The medium age is 49, neither the very young nor elderly.
cwydro
(51,308 posts)10. Yeah, scary.