๐ Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China.
BACKGROUND: Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. This study aimed to clarify the characteristics of patients with refractory COVID-19. METHODS: In this retrospective single-center study, we included 155 consecutive patients with confirmed COVID-19 in Zhongnan Hospital of Wuhan University from January 1st to February 5th. The cases were divided into general and refractory COVID-19 groups according to the clinical efficacy after hospitalization, and the difference between groups were compared. RESULTS: Compared with general COVID-19 patients (45.2%), refractory patients had an older age, male sex, more underlying comorbidities, lower incidence of fever, higher levels of maximum temperature among fever cases, higher incidence of breath shortness and anorexia, severer disease assessment on admission, high levels of neutrophil, aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein, lower levels of platelets and albumin, and higher incidence of bilateral pneumonia and pleural effusion (P<0.05). Refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorant, and adjunctive treatment including corticosteroid, antiviral drugs and immune enhancer (P<0.05). After adjustment, those with refractory COVID-19 were also more likely to have a male sex and manifestations of anorexia and fever on admission, and receive oxygen, expectorant and adjunctive agents (P<0.05) when considering the factors of disease severity on admission, mechanical ventilation, and ICU transfer. CONCLUSION: Nearly 50% COVID-19 patients could not reach obvious clinical and radiological remission within 10 days after hospitalization. The patients with male sex, anorexia and no fever on admission predicted poor efficacy.
keywords
๐ COVID-19 (1240)
๐ SARS-CoV-2 (551)
๐ clinical efficacy (2)
๐ predictors (23)
๐ pleural effusion (23)
๐ mechanical ventilation (39)
๐ novel coronavirus (684)
๐ aspartate aminotransferase (16)
๐ lactate dehydrogenase (30)
author
๐ค Mo, Pingzheng
๐ค Xing, Yuanyuan
๐ค Xiao, Yu
๐ค Deng, Liping
๐ค Zhao, Qiu
๐ค Wang, Hongling
๐ค Xiong, Yong
๐ค Cheng, Zhenshun
๐ค Gao, Shicheng
๐ค Liang, Ke
๐ค Luo, Mingqi
๐ค Chen, Tielong
๐ค Song, Shihui
๐ค Ma, Zhiyong
๐ค Chen, Xiaoping
๐ค Zheng, Ruiying
๐ค Cao, Qian
๐ค Wang, Fan
๐ค Zhang, Yongxi
year
โฐ 2020
journal
๐ Clin Infect Dis
issn
๐
volume
number
page
citedbycount
0
download
๐ [BibTeX]