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Clinical characteristics and drug therapies in patients with the common-type coronavirus disease 2019 in Hunan, China.

ABSTRACT: Background Clinical characteristics of patients with the coronavirus disease 2019 (COVID-19) may present differently within and outside the epicenter of Wuhan, China. More clinical investigations are needed. Objective The study was aimed to describe the clinical characteristics, laboratory parameters, and therapeutic methods of COVID-19 patients in Hunan, China. Setting The First Hospital of Changsha, First People's Hospital of Huaihua, and the Central Hospital of Loudi, Hunan province, China. Methods This was a retrospective multi-center case-series analysis. Patients with confirmed COVID-19 diagnosis hospitalized at the study centers from January 17 to February 10, 2020, were included. The following data were obtained from electronic medical records: demographics, medical history, exposure history, underlying comorbidities, symptoms, signs, laboratory findings, computer tomography scans, and treatment measures. Main outcome measure Epidemiological, clinical, laboratory, and radiological characteristics and treatments. Results A total of 54 patients were included (51 had the common-type COVID-19, three had the severe-type), the median age was 41, and 52% of them were men. The median time from the first symptoms to hospital admission was seven days. Among patients with the common-type COVID-19, the median length of stay was nine days, and 21 days among patients with severe COVID-19. The most common symptoms at the onset of illness were fever (74.5%), cough (56.9%), and fatigue (43.1%) among patients in the common-type group. Fourteen patients (37.8%) had a reduced WBC count, 23 (62.2%) had reduced eosinophil ratio, and 21 (56.76%) had decreased eosinophil count. The most common patterns on chest-computed tomography were ground-glass opacity (52.2%) and patchy bilateral shadowing (73.9%). Pharmacotherapy included recombinant human interferon ?2b, lopinavir/ritonavir, novaferon, antibiotics, systematic corticosteroids and traditional Chinese medicine prescription. The outcome of treatment indicated that in patients with the common-type COVID-19, interferon-?2b, but not novaferon, had some benefits, antibiotics treatment was not needed, and corticosteroids should be used cautiously. Conclusion As of February 10, 2020, the symptoms of COVID-19 patients in Hunan province were relatively mild comparing to patients in Wuhan, the epicenter. We observed some treatment benefits with interferon-?2b and corticosteroid therapies but not with novaferon and antibiotic treatment in our study population.

SUBMITTER: Huang Q

PROVIDER: S-EPMC7221339 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Clinical characteristics and drug therapies in patients with the common-type coronavirus disease 2019 in Hunan, China.

Huang Qiong Q Deng Xuanyu X Li Yongzhong Y Sun Xuexiong X Chen Qiong Q Xie Mingxuan M Liu Shao S Qu Hui H Liu Shouxian S Wang Ling L He Gefei G Gong Zhicheng Z

International journal of clinical pharmacy 20200514 3

Background Clinical characteristics of patients with the coronavirus disease 2019 (COVID-19) may present differently within and outside the epicenter of Wuhan, China. More clinical investigations are needed. Objective The study was aimed to describe the clinical characteristics, laboratory parameters, and therapeutic methods of COVID-19 patients in Hunan, China. Setting The First Hospital of Changsha, First People's Hospital of Huaihua, and the Central Hospital of Loudi, Hunan province, China. M ...[more]

PMID: 32410206

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Project description:Importance:Severe acute respiratory syndrome coronavirus 2 has caused a global outbreak of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 binds angiotensin-converting enzyme 2 of the rennin-angiotensin system, resulting in hypokalemia. Objective:To investigate the prevalence, causes, and clinical implications of hypokalemia, including its possible association with treatment outcomes, among patients with COVID-19. Design, Setting, and Participants:This cohort study was conducted at Wenzhou Central Hospital and Sixth People's Hospital of Wenzhou, Wenzhou, China, from January 11, 2020, to February 15, 2020. Participants included patients who received a diagnosis of COVID-19 according to the criteria issued by the Chinese Health Bureau and were admitted to the hospital. The patients were classified as having severe hypokalemia (plasma potassium <3 mmol/L), hypokalemia (plasma potassium 3-3.5 mmol/L), and normokalemia (plasma potassium >3.5 mmol/L). The clinical features, therapy, and outcomes were compared between the 3 groups. Data analysis was conducted in March 2020. Interventions:The patients were given general support and antiviral therapy. Their epidemiological and clinical features were collected. Main Outcomes and Measures:The prevalence of hypokalemia and response to treatment with potassium supplements were measured by analyzing plasma and urine potassium levels. Results:One hundred seventy-five patients (87 female patients [50%]; mean [SD] age, 45?[14] years) were classified as having severe hypokalemia (31 patients [18%]), hypokalemia (64 patients [37%]), and normokalemia (80 patients [46%]). Patients with severe hypokalemia had statistically significantly higher body temperature (mean [SD], 37.6 °C [0.9 °C]) than the patients with hypokalemia (mean [SD],?37.2 °C?[0.7 °C]; difference, 0.4 °C; 95% CI, 0.2-0.6 °C; P?=?.02) and the patients with normokalemia (mean [SD],?37.1 °C?[0.8 °C]; difference, 0.5 °C; 95% CI, 0.3-0.7 °C; P?=?.005). Patients with higher levels of hypokalemia also had higher creatine kinase levels (severe hypokalemia, mean [SD], 200?[257] U/L [median, 113 U/L; interquartile range {IQR}, 61-242 U/L]; hypokalemia, mean [SD], 97?[85] U/L; and normokalemia, mean [SD], 82?[57] U/L), higher creatine kinase-MB fraction (severe hypokalemia, mean [SD], 32?[39] U/L [median, 14 U/L; IQR, 11-36 U/L]; hypokalemia, mean [SD], 18?[15] U/L; and normokalemia, mean [SD], 15?[8] U/L), higher lactate dehydrogenase levels (mean [SD], severe hypokalemia, 256?[88] U/L; hypokalemia, 212?[59] U/L; and normokalemia, 199?[61] U/L), and higher C-reactive protein levels (severe hypokalemia, mean [SD], 29?[23] mg/L; hypokalemia, mean [SD], 18?[20] mg/L [median, 12, mg/L; IQR, 4-25 mg/L]; and normokalemia, mean [SD], 15?[18] mg/L [median, 6 U/L; IQR, 3-17 U/L]). Of 40 severely and critically ill patients, 34 (85%) had hypokalemia. Patients with severe hypokalemia were given potassium at a dose of 40 mEq per day, for a total mean (SD) of 453 (53) mEq potassium chloride, during the hospital stay. The patients responded well to potassium supplements as they recovered. Conclusions and Relevance:The correction of hypokalemia is challenging because of continuous renal potassium loss resulting from the degradation of angiotensin-converting enzyme 2. The high prevalence of hypokalemia among patients with COVID-19 suggests the presence of disordered rennin-angiotensin system activity, which increases as a result of reduced counteractivity of angiotensin-converting enzyme 2, which is bound by severe acute respiratory syndrome coronavirus 2.

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Dataset Information

Clinical characteristics and drug therapies in patients with the common-type coronavirus disease 2019 in Hunan, China.

Publications

Clinical characteristics and drug therapies in patients with the common-type coronavirus disease 2019 in Hunan, China.

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