Clinical Characteristics and Treatment of Patients Infected with COVID-19 in Shishou, China

Abstract

Background: (NCP) Novel coronavirus pneumonia that recently occurred in Hubei Province, China is caused by a new type of coronavirus (new coronavirus in 2019) (COVID-19)1-4 . Our research object is patients living in Shishou, Hubei Province, Shishou is a city about 300 kilometers away from Wuhan. The characteristics of patients in this city are different from those in Wuhan. We report the epidemiological and clinical characteristics of patients in this city, laboratory and radiological characteristics, as well as treatment and clinical outcomes. We also focus on how we treat the disease, how to treat it with antibiotics, hormones etc. to achieve a higher cure rate. In particular, we introduced the role of methylprednisolone in the treatment of ICU patients. The methylprednisolone protocol was developed by Wuhan Union Hospital and certified by the Chinese Ministry of Health.

Methods: All patients infected of COVID-19 were admitted to a designated hospital in Shishou. We collected and analyzed data from laboratory-confirmed COVID-19 infected patients through real-time RT-PCR and next-generation sequencing. The standardized data collection form shared by the International Federation of Severe Acute Respiratory and Emerging Infection acquired data from electronic medical records. Researchers also communicate directly with patients or their families to determine epidemiological and symptom data, the clinical characteristics and treatment methods of patients admitted to the intensive care unit (ICU) and non-ICU were also compared. The effects of clinical treatment methods were tracked, and a set of effective clinical treatment methods was proposed.

Findings: Until February 11, 2020, 89 hospitalized patients have been confirmed to have laboratory-confirmed COVID-19 infection, and many of them have recently visited Wuhan (75 [84%]), many family clusters were found (45 [50%]), we found a family of 8 people, 7 of whom were NCP patients. A small percentage of people suffer from underlying diseases (25 [28%]), including diabetes (10 [11%]), hypertension (15 [17%], but most patients entering the ICU have underlying diseases (20 [57%]), including diabetes (8 [22%]), and hypertension 12 (12 [34%]). Only 2 of the 89 patients (2%) had contact with the Huanan seafood market. Among the patients in Shishou, many family clusters were found (45 [50%]). Common symptoms at the time of onset were fever (86 of 89 patients [97%]), cough (83 [93%]), and myalgia or fatigue (30 patients [33%]). Dyspnea occurred in 27 of 30 patients (30%), Chest CT examination of all 89 patients revealed pneumonia, there are significant differences between ICU patients and non-ICU patients in the following laboratory results: D-dime, Creatine kinase, Lactate dehydrogenase, Alanine aminotransferase, Aspartate aminotransferase, Blood urea nitrogen, CRP. Regarding treatment, for non-ICU patients, we mainly use moxifloxacin, lopinavirona, and interferon treatment, which can improve most patients with mild symptoms. We appropriately added methylprednisolone to ICU patients. In the process of using methylprednisolone, according to the treatment plan formulated by Wuhan Union Hospital, certified by the Ministry of Health of China, the plan is: give the patient 40mg / bid on the first day, if the patient does not have fever, give the patient 40mg / qd on the second day, and if the patient has fever on the second day, Patients were given 40 mg / bid, the third day is the same as the second day, the fourth and fifth days were given 20 mg / qd, the current treatment effect is good, in 35 ICU patients, 26 patients have improved and transferred out of the ICU. The other 7 patients are stable and 2 have deteriorated. Currently, for the 89 patients admitted, 16 have been discharged, 1 has died, and 2 have deteriorated. The remaining patients have improved or stable.

Conclusions: COVID-19 infection causes severe respiratory disease, similar to severe acute respiratory syndrome coronavirus, and is associated with ICU entry and high mortality. We have studied the origin, epidemiology, treatment methods and other aspects, according to the treatment plan formulated by Wuhan Union Hospital, certified by the Ministry of Health of China, we hope to develop an effective treatment method to reduce the mortality of the disease.

Funding Statement: The authors stated that there was no funding available for this paper.

Declaration of Interests: The authors declare no interest.

Ethics Approval Statement: The study was approved by the Ethics Committee of Shishou People's Hospital (No. 2020001).