nCoV has features typical of the coronavirus family and was classified in the betacoronavirus 2b lineage. 7 Full-genome sequencing and phylogenic analysis indicated that 2019-nCoV is a distinct clade from the betacoronaviruses associated with human severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). 6 On January 3, 2020, the 2019 novel coronavirus (2019-nCoV) was identified in samples of bronchoalveolar lavage fluid from a patient in Wuhan and was confirmed as the cause of the NCIP. Internationally, cases have been reported in 24 countries and 5 continents. As of January 31, 2020, a total of 9692 NCIP cases in China have been confirmed. 1 - 5 The disease has rapidly spread from Wuhan to other areas. Quiz Ref ID In December 2019, a cluster of acute respiratory illness, now known as novel coronavirus–infected pneumonia (NCIP), occurred in Wuhan, Hubei Province, China.
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Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0).Ĭonclusions and Relevance In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%. As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 vs 38 ), and were more likely to have dyspnea (23 vs 20 ), and anorexia (24 vs 31 ). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 ), arrhythmia (16 ), and shock (11 ). Most patients received antiviral therapy (oseltamivir, 124 ), and many received antibacterial therapy (moxifloxacin, 89 ceftriaxone, 34 azithromycin, 25 ) and glucocorticoid therapy (62 ). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Lymphopenia (lymphocyte count, 0.8 × 10 9/L ) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds ) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L ) in 55 patients (39.9%). Common symptoms included fever (136 ), fatigue (96 ), and dry cough (82 ). Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 ) and hospitalized patients (17 ). Results Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68 range, 22-92 years) and 75 (54.3%) were men. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Outcomes of critically ill patients and noncritically ill patients were compared.
Main Outcomes and Measures Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Objective To describe the epidemiological and clinical characteristics of NCIP.ĭesign, Setting, and Participants Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to Janufinal date of follow-up was February 3, 2020. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
Importance In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.