Background: Since December 2019, a novel coronavirus pneumonia MESHD ( COVID-19 MESHD) rapidly spread in China, reached multiple continents currently.We aimed to reveal the infectious characteristics of COVID-19 MESHD that provide more information for the research of novel coronavirus. Methods: We performed a retrospective study on the clinical characteristics of 128 COVID-19 MESHD cases with laboratory-confirmed from Xiangyang No 1 Hospitalad during January 2020 to 16 February 2020. Results: Female patients account for 53.1%. The aged below 20 years that accounts for 1.6% of overall patients. The aged in 21~50, 51~65, over 66 years were accounts for 44.5%, 35.1%,18.8%, respectively. In the difference age spectrum, all severe groups compared with non-severe groups were difference significantly ( P < 0.01 ). Fever MESHD ( 89.8% ) and Cough ( 67.2% ) were common clinical symptoms. The rate of patients with sore throats (14.1%) was rare. The rate of chest computed tomography scan showing ground glass opacity in overall, non-severe, severe groups were 63.3%, 60.7%, 76.2%, respectively. White blood cell counts in the normal range of overall patients, but severe group patients were increased significantly ( P < 0.01). Lymphocytes of overall patients were decreased. Alanine transaminase (ALT) and aspartate transaminase ( AST HGNC) in the normal range of overall patients, but its were elevated in the severe group. Creatinine (CR) and blood urea nitrogen (BUN) of overall patients in the normal range. C-reactive protein HGNC ( CRP HGNC) level of all patients were increased markedly, but it in the severe group was significantly higher than that in the non-severe group ( P < 0.01 ). Conclusions: Our data provide more information that advanced age, lower lymphocytes levels at the diagnosed COVID-19 MESHD patients may be a risk factor for unfavourable prognosis. The white blood cells and C-reactive protein HGNC level elevated in severe COVID-19 MESHD patients may be accompanying bacterial infection MESHD. 2019-nCov may be carries a risk factor of impaired liver and kidney function MESHD.

Abstract BackgroundSince December 2019, Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-infected disease MESHD ( Coronavirus Disease 2019 MESHD COVID-19 MESHD) emerged in Wuhan , Chinaand rapidly spread throughout Chinaeven throughout the world. We try to describe the epidemiological and clinical characteristics of COVID-19 MESHD in non-Wuhan areaand explore its effective treatment. MethodsRetrospective, single-center case series of the 51 hospitalized patients with confirmed COVID-19 MESHD at Chongqing University Three Gorges Hospital in Chongqing, China, from January 20 to February 3, 2020The discharge time was from January 29 to February 11, 2020. The main results and indicators of epidemiology, demography, clinical manifestation, laboratory examination, imaging data and treatment data of 51 patients with covid-19 MESHD were collected and analyzed. The changes of blood routine and biochemical indexes at discharge and admission were compared. Compare the clinical characteristics of severe patients (including severe and critical patients) and non- severe patients (general patients). Results Of 51 hospitalized patients with COVID-19 MESHD, the median age was 45 years (interquartile range, 34-51; range, 16-68 years) and 32 (62.7%) were men.43(84.3%)patients had been to Wuhan or Other Hubei areas outside Wuhanand 4(7.7%) patients had a clear contact history of COVID-19 MESHD patients before the onset of the disease, and 4(7.7%) patients had no clear epidemiological history of COVID-19 MESHD.Common symptoms included fever MESHD (43 [84.3%]), cough (38 [74.5%]) and fatigue MESHD (22 [43.1%]). Lymphopenia MESHD was observed in 26 patients (51.0%), and elevated C-reactive protein HGNC level in 32 patients (62.7%). Ground-glass opacity was the typical radiological finding on chest computed tomography (41 [80.4%])Local consolidation of pneumonia MESHD in some patients(17 [33.3%]).Most of the patients were treated with traditional Chinese medicine decoction (28 [54.9%])all of them received aerosol inhalation of recombinant human interferon a-1b for injection and oral antiviral therapy with Lopinavir and Ritonavir tablets (51 [100%]); Most of the patients were given Bacillus licheniformis capsules regulated intestinal flora treatment (44 [86.3%]). 10 patients (19.6%) received short-term (3-5 days) glucocorticoid treatment. Compared with non-severe patients (n = 44), severe patients (n = 7) were older (median age, 52 years vs 44 years), had a higher proportion of diabetes mellitus (4 [57.1%] vs 0 [0.0%]), most of them needed antibiotic treatment (7 [100%] vs 4 [9.1%], most of them needed nutritional diet (6 [85.7%) vs 0 [0.0%], and were more likely to have dyspnea (6 [85.7%] vs 5 [11.4%])most of them needed noninvasive mechanical ventilation (6 [85.7%] vs 0 [0.0%]). Except one patient died, the remaining 50 patients were discharged according to the discharge standard, the common clinical symptoms disappeared basically, the lymphocyte increased significantly (P=0.008), CRP HGNC decreased significantly (P <0.001). The median length of stay was 12 days (IQR, 9-13). ConclusionIn 51 single center cases confirmed as COVID-19 MESHD and discharged from the hospital, 13.7% of the patients were severe. The main clinical symptoms of patients with COVID-19 MESHD were fever, cough and astheniaSome patients had obvious dyspnea. They had clinical laboratory and radiologic characteristics. There is no specific drug treatment for the disease. For the treatment of COVID-19 MESHD, in addition to oxygen inhalation and antiviral treatment, attention should be paid to the dialectical treatment of traditional Chinese medicine, regulation of intestinal flora, nutritional support treatment and other comprehensive treatment.

Background: Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease MESHD ( COVID-19 MESHD) outbreaks in Wuhan, China, healthcare systems capacities in highly endemic areas have been overwhelmed. Approaches to efficient management are urgently needed and key to a quicker control of the outbreaks and casualties. We aimed to characterize the clinical features of hospitalized patients with confirmed or suspected COVID-19 MESHD, and develop a mortality risk index for COVID-19 MESHD patients. Methods: In this retrospective one-centre cohort study, we included all the confirmed or suspected COVID-19 MESHD patients hospitalized in a COVID-19 MESHD-designated hospital from January 21 to February 5, 2020. Demographic, clinical, laboratory, radiological and clinical outcome data were collected from the hospital information system, nursing records and laboratory reports. Results: Of 577 patients with at least one post-admission evaluation, the median age was 55 years (interquartile range [IQR], 39 - 66); 254 (44.0%) were men; 22.8% (100/438) were severe pneumonia MESHD on admission, and 37.7% (75/199) patients were SARS-CoV-2 positive. The clinical, laboratory and radiological data were comparable between positive and negative SARS-CoV-2 patients. During a median follow-up of 8.4 days (IQR, 5.8 - 12.0), 39 patients died with a 12-day cumulative mortality of 8.7% (95% CI, 5.9% to 11.5%). A simple mortality risk index (called ACP index), composed of Age and C-reactive Protein HGNC, was developed. By applying the ACP index, patients were categorized into three grades. The 12-day cumulative mortality in grade three (age [≥] 60 years and CRP [≥] 34 mg/L) was 33.2% (95% CI, 19.8% to 44.3%), which was significantly higher than those of grade two (age [≥] 60 years and CRP < 34 mg/L; age < 60 years and CRP [≥] 34 mg/L; 5.6% [95% CI, 0 to 11.3%]) and grade one (age < 60 years and CRP < 34 mg/L, 0%) (P <0.001), respectively. Conclusion: The ACP index can predict COVID-19 MESHD related short-term mortality, which may be a useful and convenient tool for quickly establishing a COVID-19 MESHD hierarchical management system that can greatly reduce the medical burden and therefore mortality in highly endemic areas.

Summary Objective To describe the epidemiological and clinical characteristics of the Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) hospitalized patients and to offer suggestions to the urgent needs of COVID-19 MESHD prevention, diagnosis and treatment. Methods We included 102 confirmed COVID-19 MESHD cases hospitalized in Xiangyang No.1 peoples hospital, Hubei, China until Feb 9th, 2020. Demographic data, laboratory findings and chest computed tomographic (CT) images were obtained and analyzed. Findings All cases were confirmed by real-time RT-PCR, including 52 males and 50 females with a mean age of 50.38 years (SD 16.86). Incubation time ranged from one to twenty days with a mean period of 8.09 days (SD 4.99). Fever MESHD (86[84.3%] of 102 patients), cough (58[57%]), fatigue MESHD (28[27%]), shortness of breath MESHD (24[23%]), diarrhea MESHD (15[15%]), expectoration (13[12%]), inappetence (11[10%]) were common clinical manifestations. We observed a decreased blood leukocyte count and lymphopenia MESHD in 21 (20.6%) and 56 (54.9%) patients, respectively. There were 66 (68%) of 97 patients with elevated C-reactive protein HGNC levels and 49 (57.6%) of 85 with increased erythrocytes sedimentation rate. Higher levels of procalcitonin and ferritin were observed in 19 (25.3%) of 75 and 12 (92.3%) of 13 patients, respectively. Eight patients were admitted to intensive care unit (ICU), six developed respiratory failure MESHD, three had multiple organ failure MESHD and three died. The cumulative positivity rate over three rounds of real-time RT-PCR was 96%. One-hundred patients were found with typical radiological abnormalities in two rounds of chest CT scans, indicating a 98% consistency with real-time RT-PCR results. Interpretation Most COVID-19 MESHD patients in Xiangyang were secondary cases without sex difference, and the rate of severe cases and death MESHD was low. Middle-to-old-age individuals were more susceptible to the virus infection MESHD and the subsequent development of severe/fatal consequences. The average incubation period was longer among our patients. We recommend prolonging the quarantine period to three weeks. Three times real-time RT-PCR plus two times CT scans is a practical clinical diagnosis strategy at present and should be used to increase the accuracy of diagnosis, thereby controlling the source of infection more effectively. Key Words SARS-CoV-2; COVID-19 MESHD; epidemiological and clinical features; diagnosis

Background: The corona virus disease 2019 ( COVID-19 MESHD) shows unusually high transmission rate and unique clinical characteristics, with key pathological mechanism remaining unclear. Here, we analysed the laboratory data based on clinical samples from COVID-19 MESHD patients, in parallel comparison with non- COVID-19 MESHD pneumonia MESHD cases, in an attempt to elucidate the key pathological features of COVID-19 MESHD during its infection of the human body. Methods: We analysed biochemical indices and lymphocyte subpopulation in COVID-19 MESHD patients, and compare these data from non- COVID-19 MESHD pneumonia MESHD cases. Correlation analysis was performed between leukocyte subgroups count and biochemical indexes in COVID-19 MESHD patients. Results: The study enrolled 110 patients, comprising 88 COVID-19 MESHD patients and 22 non- COVID-19 MESHD pneumonia MESHD cases. We observed significant differences, including abnormal biochemical indices ( CRP HGNC, LDH, AST HGNC, eGFR HGNC, and sodium ion concentration) and reduced lymphocyte subsets count, between the COVID-19 MESHD patients and non- COVID-19 MESHD-caused pneumonia MESHD cases. Correlation analysis indicates that the count for lymphocyte subsets-but not that for neutrophils and monocytes-exhibits a significant negative correlation with biochemical indices relating to organ injury, in the COVID-19 MESHD infected MESHD patients. Conclusions: The study indicates significantly different clinical features between 2019 novel coronavirus (2019-nCoV)-caused and non-2019-nCoV-caused pneumonia MESHD, especially in terms of lymphocytopenia MESHD and organ injury. Notably, correlation analysis demonstrates that tissue damage in COVID-19 MESHD patients is attributed to virus infection MESHD itself rather than uncontrolled inflammatory responses ("cytokine storm"). These findings provide new insights for developing efficient therapeutic strategies against COVID-19 MESHD infection.

Background A new type of novel coronavirus infection MESHD ( COVID-19 MESHD) occurred in Wuhan, Hubei Province. Previous investigations reported patients in Wuhan city often progressed into severe or critical and had a high mortality rate.The clinical characteristics of affected patients outside the epicenter of Hubei province are less well understood. Methods All confirmed COVID-19 MESHD case treated in the Third People's Hospital of Shenzhen,from January 11, 2020 to February 6, 2020, were included in this study. We analyzed the epidemiological and clinical features of these cases to better inform patient management in normal hospital settings. Results Among the 298 confirmed cases, 233(81.5%) had been to Hubei while 42(14%) had not clear epidemiological history. Only 192(64%) cases presented with fever MESHD as initial symptom. The lymphocyte count decreased in 38% patients after admission. The number (percent) of cases classified as non-severe and severe was 240(80.6%) and 58(19.4%) respectively. Thirty-two patients (10.7%) needed ICU care. Compared to the non-severe cases, severe cases were associated with older age, underlying diseases, as well as higher levels of CRP HGNC, IL-6 HGNC and ESR. The median (IRQ) duration of positive viral test were 14(10-19). Slower clearance of virus was associated with higher risk of progression to severe clinical condition. As of February 14, 2020, 66(22.1%) patients were discharged and the overall mortality rate remains 0. Conclusions In a designated hospital outside the Hubei Province, COVID-19 MESHD patients were mainly characterized by mild symptoms and could be effectively manage by properly using the existing hospital system.

Background Since late December, 2019, an outbreak of pneumonia MESHD cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, and continued to spread throughout China and across the globe. To date, few data on immunologic features of Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) have been reported. Methods In this single-centre retrospective study, a total of 21 patients with pneumonia MESHD who were laboratory-confirmed to be infected with SARS-CoV-2 in Wuhan Tongji hospital were included from Dec 19, 2019 to Jan 27, 2020. The immunologic characteristics as well as their clinical, laboratory, radiological features were compared between 11 severe cases and 10 moderate cases. Results Of the 21 patients with COVID-19 MESHD, only 4 (19%) had a history of exposure to the Huanan seafood market. 7 (33.3%) patients had underlying conditions. The average age of severe and moderate cases was 63.9 and 51.4 years, 10 (90.9%) severe cases and 7 (70.0%) moderate cases were male. Common clinical manifestations including fever MESHD (100%, 100%), cough (70%, 90%), fatigue MESHD (100%, 70%) and myalgia MESHD (50%, 30%) in severe cases and moderate cases. PaO2/FiO2 ratio was significantly lower in severe cases (122.9) than moderate cases (366.2). Lymphocyte counts were significantly lower in severe cases (7000 million/L) than moderate cases (11000 million/L). Alanine aminotransferase HGNC, lactate dehydrogenase levels, high-sensitivity C-reactive protein HGNC and ferritin were significantly higher in severe cases (41.4 U/L, 567.2 U/L, 135.2 mg/L and 1734.4 ug/L) than moderate cases (17.6 U/L, 234.4 U/L, 51.4 mg/L and 880.2 ug /L). IL-2R HGNC, TNF HGNC- and IL-10 HGNC concentrations on admission were significantly higher in severe cases (1202.4 pg/mL, 10.9 pg/mL and 10.9 pg/mL) than moderate cases (441.7 pg/mL, 7.5 pg/mL and 6.6 pg/mL). Absolute number of total T lymphocytes, CD4+T cells and CD8+T cells decreased in nearly all the patients, and were significantly lower in severe cases (332.5, 185.6 and 124.3 million/L) than moderate cases (676.5, 359.2 and 272.0 million/L). The expressions of IFN-{gamma HGNC} by CD4+T cells tended to be lower in severe cases (14.6%) than moderate cases (23.6%). Conclusion The SARS-CoV-2 infection MESHD may affect primarily T lymphocytes, particularly CD4+T cells, resulting in significant decrease in number as well as IFN-{gamma HGNC} production, which may be associated with disease severity. Together with clinical characteristics, early immunologic indicators including diminished T lymphocytes and elevated cytokines may serve as potential markers for prognosis in COVID-19 MESHD.

An increasing number of cases of novel coronavirus pneumonia (NCP) infected MESHD NCP PROTEIN) infected with 2019-nCoV have been identified in Wuhan and other cities in China, since December 2019. We analyzed data on the 17 confirmed cases in Dazhou to provide the epidemiologic characteristics of NCP PROTEIN outside Wuhan. Among them, 12 patients were still quarantined in the hospital, 5 patients were discharged NCP PROTEIN patients according to the national standards. Compared with non-discharged NCP PROTEIN patients, the discharged NCP PROTEIN patients had younger ages. Moreover, discharged NCP PROTEIN patients had higher heart rate, lymphocytes levels and monocytes levels than non-discharged NCP PROTEIN patients on admission to the hospital. Notably, all of 17 patients had abnormal increased C-reactive protein HGNC levels, and 16 patients had abnormal computed tomography images. This study provided some information that younger age, higher lymphocytes levels and monocytes levels at the diagnoses of 2019-nCoV may contributed to faster recovery and better therapeutic outcome.