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Clinical Characteristics and Progression of 2019 Novel Coronavirus-Infected Patients Concurrent Acute Respiratory Distress Syndrome

By Yanli Liu, Wenwu Sun, Jia Li, Liangkai Chen, Yujun Wang, Lijuan Zhang, Li Yu

Posted 20 Feb 2020
medRxiv DOI: 10.1101/2020.02.17.20024166

BackgroundIn December 2019, the outbreak of novel coronavirus (2019-nCoV) infection lead to a cluster of pneumonia cases. We report the clinical characteristics of 2019-nCoV infected patients with acute respiratory distress syndrome (ARDS) and further investigate the treatment and the progression of the disease. MethodsThe longitudinal study included 109 patients with novel coronavirus-infected pneumonia (COVID-19) admitted to the Central Hospital of Wuhan between January 2 and February 1, 2020. Patients were followed up to February 12, 2020. Epidemiological, clinical, and laboratory characteristics, treatment, and outcomes data were collected from electronic medical records. The difference in treatment and progression between patients with ARDS and without ARDS was compared. ResultsAmong 109 patients with COVID-19, the median age was 55 years (IQR, 43-66 years; range, 22-94 years), and 59 (54.1%) patients were men. The median hospital days were 15 days (interquartile range, 11-24 days), and 31 (28.4%) patients had died and 78 (71.6%) survived. Among them, 53 (48.6%) patients developed ARDS. Compared with non-ARDS patients, patients with ARDS were more likely to have coexisting conditions, including diabetes (20.8% vs. 1.8%), cerebrovascular (11.3% vs. 0%) and chronic kidney disease (15.1% vs. 3.6%). Compared with patients with mild ARDS (n = 1/19 [5.3%]), those with moderate and severe ARDS had a higher mortality rate (n = 15/24 [62.5%] for moderate ARDS and n = 10/10 [100.0%] for severe ARDS). The mortality rate increased concomitantly with the severity of ARDS. We have not observed a significant effect of antivirus, glucocorticoid, or immunoglobulin treatment on survival in patients with ARDS. ConclusionsOur findings indicated that 2019-nCoV infected patients with moderate-to-severe ARDS had higher mortality rates and the beneficial effects of current treatments were not satisfactory, which are warranted attention from clinicians.

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