Clinical and radiological characteristics of COVID-19: a multicentre, retrospective, observational study

• Published in: Hong Kong medical journal = Xianggang yi xue za zhi Vol. 27; no. 1; pp. 7 - 17
• Main Authors: Wang, Y, Luo, S, Zhou, C S, Wen, Z Q, Chen, W, Liao, W H, Liu, J, Yang, Y, Shi, J C, Liu, S D, Xia, F, Yan, Z H, Lu, X, Chen, T, Yan, F, Zhang, B, Zhang, D Y, Sun, Z Y
• Format: Journal Article
• Language: English
• Published: China Hong Kong Academy of Medicine 01.02.2021
• Subjects: Adult; China - epidemiology; Comorbidity; Coronaviruses; COVID-19; COVID-19 - diagnostic imaging; COVID-19 - epidemiology; Data collection; Disease; Dyspnea; Epidemics; Female; Fever; Hospitalization; Hospitals; Humans; Hypertension; Hypoxia; Infections; Laboratories; Male; Morbidity; Patients; Pneumonia; Pneumonia, Viral - diagnostic imaging; Pneumonia, Viral - epidemiology; Pneumonia, Viral - virology; Provinces; Radiography, Thoracic; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Tomography, X-Ray Computed; China; Hubei China; COVID-19; Hypertension; Severe acute respiratory syndrome coronavirus 2; Hypoxia; Dyspnea; Lymphopenia
• ISSN: 1024-2708; 2226-8707
• DOI: 10.12809/hkmj208725

Multicentre cohort investigations of patients with coronavirus disease 2019 (COVID-19) have been limited. We investigated the clinical and chest computed tomography characteristics of patients with COVID-19 at the peak of the epidemic from multiple centres in China. We retrospectively analysed the epidemiologic, clinical, laboratory, and radiological characteristics of 189 patients with confirmed COVID-19 who were admitted to seven hospitals in four Chinese provinces from 18 January 2020 to 3 February 2020. The mean patient age was 44 years and 52.9% were men; 186/189 had ≥1 co-existing medical condition. Fever, cough, fatigue, myalgia, diarrhoea, and headache were common symptoms at onset; hypertension was the most common co-morbidity. Common clinical signs included dyspnoea, hypoxia, leukopenia, lymphocytopenia, and neutropenia; most lesions exhibited subpleural distribution. The most common radiological manifestation was mixed ground-glass opacity with consolidation (mGGO-C); most patients had grid-like shadows and some showed paving stones. Patients with hypertension, dyspnoea, or hypoxia exhibited more severe lobe involvement and diffusely distributed lesions. Patients in severely affected areas exhibited higher body temperature; more fatigue and dyspnoea; and more manifestations of multiple lesions, lobe involvement, and mGGO-C. During the Wuhan lockdown period, cough, nausea, and dyspnoea were alleviated in patients with newly confirmed COVID-19; lobe involvement was also improved. Among patients with COVID-19 hospitalised at the peak of the epidemic in China, fever, cough, and dyspnoea were the main symptoms at initial diagnosis, accompanied by lymphocytopenia and hypoxaemia. Patients with severe disease showed more severe lobe involvement and diffuse pulmonary lesion distribution.