Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2020; 8(21): 5188-5202
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5188
Epidemiological and clinical characteristics of fifty-six cases of COVID-19 in Liaoning Province, China
Jing-Bo Wang, Hai-Tao Wang, Lei-Shi Wang, Lu-Ping Li, Jiao Xv, Chun Xv, Xing-Hai Li, Yun-Hai Wu, Hong-Yan Liu, Bai-Jun Li, Hong Yu, Xia Tian, Zhi-Yu Zhang, Yan Wang, Rui Zhao, Jin-Yang Liu, Wei Wang, Ye Gu
Jing-Bo Wang, Lei-Shi Wang, Jiao Xv, Chun Xv, Xing-Hai Li, Hong-Yan Liu, Bai-Jun Li, Hong Yu, Xia Tian, Yan Wang, Rui Zhao, Wei Wang, Ye Gu, Department of Infectious Disease, The Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
Hai-Tao Wang, Department of General Surgery, The Second Affiliated Hospital of Shenyang Medical College, Shenyang 110002, Liaoning Province, China
Lu-Ping Li, Department of Clinical Laboratory, The Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
Yun-Hai Wu, Department of Intensive Critical Medicine, The Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
Zhi-Yu Zhang, Jin-Yang Liu, Department of Infectious Diseases Clinic, The Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
Author contributions: Wang JB, Wang HT, and Gu Y designed the research study; Wang HT and Gu Y provided administrative support; Li XH, Wu YH, Liu HY, Li BJ, Yu H, Tian X, Zhang ZY, Wang Y, Zhao R, Liu JY, and Wang W performed the research and provided clinical advice; Wang JB, Wang LS, Li LP, Xu J, Xu C, and Wang HT contributed to the analysis; Wang JB and Wang HT wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Sixth People’s Hospital of Shenyang.
Informed consent statement: Written informed consent was not obtained due to the urgent need for clinical data.
Conflict-of-interest statement: We have no financial relationships to disclose.
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: Ye Gu, MD, Chief Doctor, Department of Infectious Disease, The Sixth People’s Hospital of Shenyang, No. 85 Hepingnan Street, Shenyang 110006, Liaoning Province, China. gu3311@126.com
Received: May 12, 2020
Peer-review started: May 12, 2020
First decision: August 21, 2020
Revised: August 31, 2020
Accepted: September 22, 2020
Article in press: September 22, 2020
Published online: November 6, 2020
Processing time: 177 Days and 22 Hours
Abstract
BACKGROUND

Pneumonia of uncertain cause has been reported in Wuhan, China since the beginning of early December 2019. In early January 2020, a novel strain of β-coronavirus was identified by the Chinese Center for Disease Control and Prevention from the pharyngeal swab specimens of patients, which was recently named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is evidence of human-to-human transmission and familial cluster outbreak of SARS-CoV-2 infection. The World Health Organization(WHO) recently declared the SARS-CoV-2 epidemic a global health emergency. As of February 17, 2020, 71329 laboratory-confirmed cases (in 25 countries, including the United States and Germany) have been reported globally. Other than its rapid transmission, the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) remain unclear. In December 2019, coronavirus disease (named COVID-19 by the WHO) associated with the SARS-CoV-2 emerged in Wuhan, China and spread quickly across the country.

AIM

To analyze the epidemiological and clinical characteristics of confirmed cases of this disease in Liaoning province, a Chinese region about 1800 km north of Wuhan.

METHODS

The clinical data of 56 laboratory-confirmed COVID-19 cases due to 2019-nCoV infection were analyzed. The cases originated from eight cities in Liaoning province.

RESULTS

The median age of the patients was 45 years, and 57.1% of them were male. No patient had been in direct contact with wild animals. Among them, 23 patients (41.1%) had resided in or traveled to Wuhan, 27 cases (48.2%) had been in contact with confirmed COVID-19 patients, 5 cases (8.9%) had been in contact with confirmed patients with a contact history to COVID-19 patients, and 1 case (1.8%) had no apparent history of exposure. Fever (75.0%) and cough (60.7%) were the most common symptoms. The typical manifestations in lung computed tomography (CT) included ground-glass opacity and patchy shadows, with 67.8% of them being bilateral. Among the patients in the cohort, 78.6% showed reduction in their lymphocyte counts, 57.1% showed increases in their C-reactive protein levels, and 50.0% showed decreases in their blood albumin levels. Eleven patients (19.6%) were admitted to intensive care unit, 2 patients (3.5%) progressed to acute respiratory distress syndrome, 4 patients (7.1%) were equipped with non-invasive mechanical ventilation, and 1 patient (1.8) received extracorporeal membrane oxygenation support. There were 5 mild cases (5/56, 8.9%), 40 moderate cases (40/56, 71.4%), 10 severe cases (10/56, 17.9%), and 1 critical case (1/56, 1.8%). No deaths were reported.

CONCLUSION

SARS-CoV-2 can be transmitted among humans. Most COVID-19 patients show symptoms of fever, cough, lymphocyte reduction, and typical lung CT manifestations. Most are moderate cases. The seriousness of the disease (as indicated by blood oxygen saturation, respiratory rate, oxygenation index, blood lymphocyte count, and lesions shown in lung CT) is related to history of living in or traveling to Wuhan, underlying diseases, admittance to intensive care unit, and mechanical ventilation.

Keywords: SARS-CoV-2; COVID-19; Epidemiological characteristics; Clinical characteristics; Hypoxemia; Acute respiratory distress syndrome

Core Tip: This is a retrospective, single-center study on the clinical characteristics of laboratory-confirmed coronavirus disease 2019 (COVID-19) cases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We summarized the clinical data of 56 patients with COVID-19 diagnosed and treated in Liaoning. The main conclusion is SARS-CoV-2 can be transmitted among humans, and cases were mainly imported and were moderate. Severe cases were characterized by severe hypoxemia, lymphocytopenia, pulmonary consolidation, admittance to intensive care unit, and mechanical ventilation. Infection of SARS-CoV-2 and seriousness of COVID-19 are related to old age and underlying diseases.