Patient characteristics
A total of 239 adult inpatients at Wuhan Tongji Hospital (Wuhan, China)
who were diagnosed with COVID-19 according to to the Chinese management
guideline for COVID-19 (version 7.0) and the World Health Organization
interim guidance were included in this retrospective study. Five
patients is excluded for death with positive pharyngeal swab
test.(Figure1).In this patient population, the
median age was 63.0 years old
(IQR, 52.0, 72.0). Of the 239 patients, 50.2% (120/239) were male,
18.8% (45/239) of the patients progressed to critical illness (Table
1). Patients were considered progressing to critical illness if at least
one of the following conditions were observed: 1. Respiratory failure
requiring mechanical ventilation; 2. Shock; 3. Combined organ failure
requiring monitoring and treatment in the intensive care unit (ICU).
Of the 239 patients, 13.8% (33/239) died during the first 28 days of
hospitalization. The most common
symptoms among the patients were fever 79.1% (189/239) and cough 79.9%
(191/239). The most common reported comorbidity was hypertension 37.7%
(90/239). For all patients in the retrospective study, the median viral
RNA shedding duration time was 26 days (IQR, 20.0, 34.0). The median
time from onset of symptoms to patient diagnosis with COVID-19 was 7
days (IQR,3.0, 13.0). The median time from onset of illness to inpatient
admission at the hospital was 15 days (IQR,10.0, 21.0) and the median
time from onset of illness to treatment with antiviral therapies was 5
days (IQR,1.0, 12.0).
Patients with prolonged viral RNA shedding duration (≥ 26 days) were
younger (61.5 ys vs. 66.0 ys, P= 0.02), had a lower APACHE
II score (5.0 vs. 6.0 , P < 0.01), a lower
hs-CRP levels (3.6 mg/L vs. 8.9 mg/L, P= 0.03), and a
higher lymphocyte count (1.4 ×109 /L vs.1.2×109 /L, P < 0.01). Patients with
a long viral RNA shedding duration had a viral RNA shedding duration 1.7
times greater than patients with a short viral RNA shedding duration (34
days vs. 20 days, P < 0.01). Patients with a
long viral RNA shedding duration also had a longer time from illness
onset to diagnosis with COVID-19 (10 days vs. 4 days, P< 0.01), to hospital admission (7 days vs. 4 days,P < 0.01), and to antiviral treatment (19 daysvs. 10 days, P < 0.01).