Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Importance: In December 2019, novel coronavirus (2019-nCoV) -infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited. Objective: To describe the epidemiological and clinical characteristics of NCIP. Design, Setting, and Participants: Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020. Exposures: Documented NCIP. Main Outcomes and Measures: Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Results: Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54. 3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 29%) and hospitalized patients (17 12. 3%). Common symptoms included fever (136 98. 6%), fatigue (96 69. 6%), and dry cough (82 59. 4%). Lymphopenia (lymphocyte count, 0. 8 × 109/L interquartile range IQR, 0. 6-1. 1) occurred in 97 patients (70. 3%), prolonged prothrombin time (13. 0 seconds IQR, 12. 3-13. 7) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L IQR, 182-403) in 55 patients (39. 9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 89. 9%), and many received antibacterial therapy (moxifloxacin, 89 64. 4%; ceftriaxone, 34 24. 6%; azithromycin, 25 18. 1%) and glucocorticoid therapy (62 44. 9%). Thirty-six patients (26. 1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 61. 1%), arrhythmia (16 44. 4%), and shock (11 30. 6%). The median time from first symptom to dyspnea was 5. 0 days, to hospital admission was 7. 0 days, and to ARDS was 8. 0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 72. 2% vs 38 37. 3%), and were more likely to have dyspnea (23 63. 9% vs 20 19. 6%), and anorexia (24 66. 7% vs 31 30. 4%). Of the 36 cases in the ICU, 4 (11. 1%) received high-flow oxygen therapy, 15 (41. 7%) received noninvasive ventilation, and 17 (47. 2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34. 1%) were discharged and 6 died (overall mortality, 4. 3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7. 0-14. 0). Conclusions and Relevance: In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4. 3%.