Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 11:7:485.
doi: 10.3389/fmed.2020.00485. eCollection 2020.

Clinical Characteristics and Prognosis of 218 Patients With COVID-19: A Retrospective Study Based on Clinical Classification

Xiquan Yan  1   2   3 , Xiaotong Han  1 , Danhong Peng  4 , Yong Fan  5 , Zhixiong Fang  6 , Da Long  7 , Yu Xie  8 , Shuibo Zhu  9 , Fang Chen  1 , Wei Lin  1 , Yimin Zhu  1   2
Affiliations

Clinical Characteristics and Prognosis of 218 Patients With COVID-19: A Retrospective Study Based on Clinical Classification

Xiquan Yan et al. Front Med (Lausanne). .

Abstract

Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that has spread worldwide. Methods: This was a retrospective case series involving 218 patients admitted to three tertiary hospitals in the Loudi, Shaoyang, and Xiangtan areas of China from January 21 to June 27, 2020, who were confirmed by RT-PCR to have SARS-CoV-2. The patients' clinical characteristics, laboratory results, treatments, and prognoses based on clinical classification were recorded. Poor outcome was defined as admission to an ICU, the use of mechanical ventilation, or death. Results: The patients were classified into four clinical groups based on disease severity, namely mild (10/218, 5%), moderate (146/218, 67%), severe (24/218, 11%), or critical (14/218, 6%); 24 (11%) asymptomatic cases were also included in the study. The most common symptoms were self-reported cough (162/218, 74%), fever (145/218, 67%), sputum production (99/218, 45%), and fatigue (77/218, 35%). Among the 218 patients, 192 (88%) received lopinavir/ritonavir and interferon-alpha inhalation, and 196 (90%) patients received traditional Chinese medicine. Among the severe and critical patients, 25 (11%) were admitted to an ICU with or without mechanical ventilation, and one patient died. The presence of diabetes [relative risk (RR), 3.0; 95% CI, 1.3-6.8; p = 0.007) or other comorbidities (RR, 5.9; 95% CI, 1.9-17.8; p = 0.002) was independently associated with poor outcome. To date, 20 (9%) patients have retested positive for SARS-CoV-2 RNA after recovering and being discharged. Conclusion: The majority of patients in this case series were clinically classified as having moderate COVID-19. Older patients tended to present with greater levels of clinical severity. The prognosis for patients who were elderly or had diabetes or other chronic comorbidities was relatively poor.

Keywords: COVID-19; clinical characteristics; clinical classification; prognosis; treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Clinical classification (including asymptomatic cases) and age distribution of patients with COVID-19.
Figure 2
Figure 2
Axial planes and coronal chest CT scans in patients with COVID-19. Moderate case: (A,B) Chest CT images of a 41-year-old man showed a ground-glass lesion in the right lobe on the 3rd day following a fever. Severe case: (C,D) Chest CT images of a 55-year-old woman showed bilateral multifocal ground-glass opacities on the 8th day after having chills, cough, and expectoration. Critical case: (E,F) Chest CT images of a 61-year-old man showed diffuse patchy shadowing and mixed consolidation on the 13th day after having cough, expectoration, and fever.
Figure 3
Figure 3
Time from admission to poor outcome based on the presence of a comorbid disease. Poor outcome was defined as death or intensive care unit admission with or without mechanical ventilation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. . A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. (2020) 382:727–33. 10.1056/NEJMoa2001017 - DOI - PMC - PubMed
    1. WHO Coronavirus Disease (COVID-2019) Situation Reports. Available online at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio... (accessed April 18, 2020)
    1. Thompson R. Pandemic potential of 2019-nCoV. Lancet Infect Dis. (2020) 20:280. 10.1016/S1473-3099(20)30068-2 - DOI - PMC - PubMed
    1. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. (2020) 395:470–3. 10.1016/S0140-6736(20)30185-9 - DOI - PMC - PubMed
    1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. . Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. (2020) 395:507–13. 10.1016/S0140-6736(20)30211-7 - DOI - PMC - PubMed