Diagnosis and treatment of 471 patients with 2019 novel coronavirus disease (COVID-19)

BACKGROUND: While the 2019 novel coronavirus disease (COVID-19) outbreak has been largely kept under control in China, it remains a global pandemic, and the source, transmission route, and treatments of SARS-COV-2 are still being investigated Here, we summarized the clinical features, diagnosis, treatment, and prognosis of COVID-19 patients based on our clinical practice METHODS: The clinical and imaging findings, treatments, and follow-up data of 471 patients with COVID-19 who were discharged from the Wuhan Jinyintan Hospital prior to February 6, 2020, were retrospectively analyzed RESULTS: Among these patients, there were 2 mild cases, 282 moderate cases, 181 severe cases, and 6 critical cases There were 250 males and 221 females aged 17 to 90 years The median age was 54 years in the severe/critical group, which was significantly older than in the mild/moderate group (P<0 05) 44 59% of them had one or more underlying diseases The most common symptoms were fever, cough, expectoration, and dyspnea The median body temperature in the severe/critical group was 39°C, which was significantly higher than in the mild/moderate group (P<0 05) The incidences of lymphopenia and CD4(+) T lymphocytopenia were 53 5% and 41 86%, respectively Ground-glass opacity and small patchy shadows were the most common findings on chest computed tomography (CT) Compared with the mild/moderate group, the severe/critical group showed higher proportions of severe lymphocytopenia and CD4(+) T lymphocytopenia, along with more ground-glass shadows and large-scale consolidation After anti-infection, oxygen therapy, and symptomatic support, lymphocytes and CD4(+) T lymphocytes were markedly increased, all patients were discharged The median time of nucleic acid conversion and hospital stay were 9 and 12 days, respectively, which were significantly longer in the severe/critical group than in the mild/moderate group Of the 390 cases followed, only 19 were hospitalized again due to other diseases All patients recovered well from COVID-19, with negative nucleic acid test results CONCLUSIONS: Lymphocytopenia and CD4(+) T lymphocytopenia were found to be associated with COVID-19 and thus may be important indicators in evaluating the severity and prognosis Multidisciplinary management including antiviral treatment, immune regulation, and symptomatic support is effective, and yields a low recurrence rate