Analysis Of Epidemiological And Clinical Characteristics Of Patients With Corona Virus Disease 2019

Objective:To investigate and analyze the general information,epidemiological and clinical characteristics of patients with corona virus disease 2019(COVID-19)in Shaoyang of Hunan province,find out the influence facters associated with acute respiratory distress syndrome(ARDS),and provide reference for the prevention and treatment of ARDS.Methods:95 patients who were confirmed with COVID-19 in Shaoyang of Hunan were analyzed,which were reported from January 23 to March 2,2020.The general information,epidemiological characteristics and clinical characteristics between 15 ARDS ill cases and 80 non-ARDS ill cases were compared to find out the influence facters associated with ARDS.Results:1.The general information and epidemiological investigation.Of 95patients with COVID-19,47 cases(49.5%)were men,48 cases(50.5%)were women,and the average age was(43.4±16.3)years.23 patients(24.2%)were severe/critical cases,15 patients(15.8%)developed ARDS,two patients died(one patient died in the hospital,the other died outside the hospital after severe acute respiratory syndrome coronavirus 2 nucleic acid turned negative),mortality was 13.3%(2/15).The epidemiological characteristics of cases with COVID-19 in Shaoyang are mainly Wuhan imported cases and clustered cases,91.6%(87/95)of the patients had a history of close contact with infectious sources,a total of 69 cases(72.6%)were clustered patients,however,the spread of virus had not occurred in communities and hospitals.Asymptomatic infected patients might become virus carrier.2.Clinical data.In those who developed ARDS,compared with those who did not,patients were older[(60.5±17.5)years VS(40.6±15.8)years,P=0.001]and presented with higher respiratory rates[20(20～22)rates/min VS 20(18～20)rates/min,P=0.011]and higher APACHEⅡscores[5(1～6)scores VS 2(1～3)scores,P=0.019],more patients had comorbidity with hypertension(40.0%VS 8.8%,P=0.001)and had complications such as bacterial infection(80.0%VS 7.5%,P=0.001),shock(20.0%VS 0.0%,P=0.001),acute renal failure(13.3%VS 0.0%,P=0.001)and acute cardiac dysfunction(26.7%VS 3.8%,P=0.002),all of the above,the differences between two groups were statistically significant(all P<0.05).More patients of ARDS group showed lymphopenia[0.7(0.5～0.8)×10~9/L VS1.1(0.8～1.7)×10~9/L,P=0.001],leukocytosis[8.7(4.3～12.8)×10~9/L VS5.0(3.9～6.8)×10~9/L,P=0.011],higher neutrophils[7.8(4.0～10.5)×10~9/L VS 3.2(2.3～4.3)×10~9/L,P=0.001]as well as higher levels of D-dimer[0.5(0.4～0.6)g/L VS 0.3(0.2～0.5)g/L,P=0.001],urea nitrogen[5.9(4.6～6.5)mmol/L VS 3.7(3.0～4.6)mmol/L,P=0.001],creatine[80.0(69.0～88.0)μmol/L VS 64.0(49.0～77.0)μmol/L,P=0.004],creatine kinase[115.0(53.0～180.0)U/L VS 71.0(51.0～104.0)U/L,P=0.028],C-reactive protein(80.0%VS 42.5%,P=0.008),procalcitonin(53.3%VS17.5%,P=0.003).All of the above,the differences between two groups were statistically significant(all P<0.05).Compared to non-ARDS group,Chest CT scan were showed higher proportion with bilateral involvement in ARDS group,but the difference between 2 groups was no statistically significant(93.3%VS 70.0%,P=0.060).3.Influence factors of ARDS.Logistic regression analysis showed that leukocytosis(OR=12.788,95%CI 1.359～120.314,P=0.026),higher levels of D-dimer(OR=20.256,95%CI 1.063～386.098,P=0.045)and bacterial infection(OR=198.555,95%CI 9.597～4107.865,P=0.001)were risk factors of development of ARDS in COVID-19 patients.Conclusions:1.91.6%of COVID-19 patients in Shaoyang had a history of close contact with a definite source of infection,72.6%of them were clustered patients,the epidemiological characteristics of cases are mainly Wuhan imported cases and clustered cases.2.The incidence of ARDS in patients with COVID-19 was 15.8%,leukocytosis,higher level of D-dimer and bacterial infection might be the risk factors of development of ARDS in COVID-19 patients.