Prospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2020; 8(12): 2554-2565
Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2554
Epidemiological and clinical characteristics of COVID-19 patients in Hengyang, Hunan Province, China
Zhe-Feng Zhong, Jia Huang, Xia Yang, Jin-Ling Peng, Xiao-Yan Zhang, Yang Hu, Nian Fu, Hai-Lian Lin, Bo Jiang, Ya-Ying Tian, Hong-Yi Yao, Li-Pu Deng, Xiao-Qing Tang, Jie-Can Zhou, Jian Tang, Xia Xie, Qiong Liu, Jing Liu, Cheng-Yun Dou, Rong-Juan Dai, Bo Yan, Xue-Feng Yang
Zhe-Feng Zhong, Bo Jiang, Ya-Ying Tian, Department of Infectious Diseases, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
Jia Huang, Yang Hu, Nian Fu, Hai-Lian Lin, Xue-Feng Yang, Department of Gastroenterology, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
Xia Yang, Jin-Ling Peng, Xiao-Yan Zhang, Department of General Practice, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
Hong-Yi Yao, Li-Pu Deng, Department of Intensive Medicine, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
Xiao-Qing Tang, Institute of Clinical Medicine, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
Jie-Can Zhou, Jian Tang, Xia Xie, Qiong Liu, Jing Liu, Cheng-Yun Dou, Rong-Juan Dai, Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
Bo Yan, Department of Cardiology, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
Author contributions: Zhong ZF and Huang J equally contributed to this work; Yang XF and Tang XQ designed the study and edited the manuscript; Zhong ZF, Hu Y, Deng LP, Jiang B, Tian YY, Yao HY, Zhou JC, Tang J, Xie X, Liu Q, Liu J, Dou CY, and Dai RJ participated in data collection; Yang X, Peng JL, Zhang XY, Yan B, and Fu N took part in data sorting; Yang XF, Huang J, and Lin HL carried out statistical analysis; all the authors read and approved the final version of the manuscript.
Supported by the Novel Coronavirus Pneumonia Emergency Project of University of South China, No. 2020-15 and No. 2020-25; the Hengyang Science and Technology Plan Project-Basic Research Project of Prevention and Treatment of the Novel Coronavirus Pneumonia, No. 202010031577; the Scientific Research Project of Hunan Provincial Health and Family Planning Commission, No. A2017015; the Natural Science Foundation of Hunan Province, China, No. 2016JJ5010; and the National Natural Science Foundation of China, No. 81373465.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki, and it was approved by the Ethics Committee of Affiliated Nanhua Hospital of the University of South China.
Clinical trial registration statement: This study is not a clinical trial study.
Informed consent statement: All the patients signed a written informed consent form prior to commencing the study.
Conflict-of-interest statement: All the authors declare that there is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xue-Feng Yang, MD, Full Professor, Department of Gastroenterology, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, No. 336, Dongfeng Road, Zhuhui District, Hengyang 421002, Hunan Province, China. yxf9988@126.com
Received: March 13, 2020
Peer-review started: March 13, 2020
First decision: March 27, 2020
Revised: May 15, 2020
Accepted: June 2, 2020
Article in press: June 2, 2020
Published online: June 26, 2020
Processing time: 102 Days and 16.8 Hours
Abstract
BACKGROUND

In December 2019, an ongoing outbreak of coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China. The characteristics of COVID-19 patients treated in local hospitals in Wuhan are not fully representative of patients outside Wuhan. Therefore, it is highly essential to analyze the epidemiological and clinical characteristics of COVID-19 in areas outside Wuhan or Hubei Province. To date, a limited number of studies have concentrated on the epidemiological and clinical characteristics of COVID-19 patients with different genders, clinical classification, and with or without basic diseases.

AIM

To study the epidemiological and clinical characteristics of COVID-19 patients in Hengyang (China) and provide a reliable reference for the prevention and control of COVID-19.

METHODS

From January 16 to March 2, 2020, a total of 48 confirmed cases of COVID-19 were reported in Hengyang, and those cases were included in this study. The diagnostic criteria, clinical classification, and discharge standard related to COVID-19 were in line with the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7) released by National Health Commission and National Administration of Traditional Chinese Medicine. The presence of SARS-CoV-2 in pharyngeal swab specimens was detected by quantitative reverse transcription polymerase chain reaction. All the data were imported into the excel worksheet and statistically analyzed by using SPSS 25.0 software.

RESULTS

A total of 48 cases of COVID-19 were collected, of which 1 was mild, 38 were moderate, and 9 were severe. It was unveiled that there were 31 (64.6%) male patients and 17 (35.4%) female patients, with a female-to-male ratio of 1.82:1. The range of age of patients with COVID-19 was dominantly 30-49 years old [25 (52.1%) of 48], followed by those aged over 60 years old [11 (22.9%)]. Besides, 29.2% (14 of 48) of patients had basic diseases, and 57.2% (8 of 14) of patients with basic diseases were aged over 60 years old. The occupations of 48 COVID-19 patients were mainly farmers working in agricultural production [15 (31.5%) of 48], rural migrant workers from Hengyang to Wuhan [15 (31.5%)], and service workers operating in the service sector [8 (16.7%)]. The mean latent period was 6.86 ± 3.57 d, and the median was 7 [interquartile range (IQR): 4-9] d. The mean time from onset of symptoms to the first physician visit was 3.38 ± 2.98 (95%CI: 2.58-9.18) d, with a median of 2 (IQR: 1-5) d, and the mean time from hospital admission to confirmed diagnosis was 2.29 ± 2.11 (95%CI: 1.18-6.42) d, with a median of 2 (IQR: 1-3) d. The main symptoms were fever [43 (89.6%) of 48], cough and expectoration [41 (85.4%)], fatigue [22 (45.8%)], and chills [22 (45.8%)]. Other symptoms included poor appetite [13 (27.1%)], sore throat [9 (18.8%)], dyspnea [9 (18.8%)], diarrhea [7 (14.6%)], dizziness [5 (10.4%)], headache [5 (10.4%)], muscle pain [5 (10.4%)], nausea and vomiting [4 (8.3%)], hemoptysis [4 (8.3%)], and runny nose [1 (2.1%)]. The numbers of peripheral blood leukocytes, lymphocytes, and eosinophils were significantly reduced in the majority of the patients. The levels of C-reactive protein, fibrinogen, blood glucose, lactate dehydrogenase, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GT), myoglobin (MB), and creatine kinase (CK) were increased in 64.6%, 44.7%, 43.2%, 37.0%, 29.5%, 22.9%,20.8%, 21.6%, 13.6%, and 12.8% of patients, respectively. The incidence of ALT elevation in male patients was remarkably higher than that in females (P < 0.01), while the incidences of AST, CK, and blood glucose elevations in severe patients were remarkably higher than those in moderate patients (P < 0.05, respectively). Except for the mild patients, chest computed tomography showed characteristic pulmonary lesions. All the patients received antiviral drugs, 38 (79.2%) accepted traditional Chinese medicine, and 2 (4.2%) received treatment of human umbilical-cord mesenchymal stem cells. On March 2, 2020, 48 patients with COVID-19 were all cured and discharged.

CONCLUSION

Based on our results, patients with COVID-19 often have multiple organ dysfunction or damage. The incidences of ALT elevation in males, and AST, CK, and blood glucose elevations in severe patients are remarkably higher.

Keywords: Novel coronavirus pneumonia; COVID-19; SARS-CoV-2; Epidemiology; Hengyang; Coronavirus disease 2019

Core tip: To study the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) patients with different genders, clinical classification, and with or without basic diseases could provide more information for COVID-19 prevention and control. Our research found that many patients with COVID-19 had multiple organ dysfunction or damage. The higher attention of the government and residents on the prevention and control of COVID-19 was the key factor to control the development of COVID-19 epidemic. Wearing masks and home isolation could effectively cut off transmission routes and prevent the spread of the novel coronavirus.