Clinical characteristics of the coronavirus disease 2019 (COVID-19) outbreak on a cruise ship

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 26; no. 11; pp. 1177 - 1180
• Main Authors: Yoshimura, Yukihiro, Sasaki, Hiroaki, Horiuchi, Hiroshi, Miyata, Nobuyuki, Tachikawa, Natsuo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.11.2020; Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd
• Subjects: Aged; Betacoronavirus - genetics; Betacoronavirus - isolation & purification; Clinical Laboratory Techniques - statistics & numerical data; Coronavirus infection; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - virology; COVID-19; COVID-19 Testing; Cruise; Disease Outbreaks - statistics & numerical data; Female; Humans; Japan - epidemiology; Male; Middle Aged; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - virology; Polymerase Chain Reaction - statistics & numerical data; Retrospective Studies; RNA, Viral - isolation & purification; SARS-CoV-2; Ships - statistics & numerical data; Travel-Related Illness; Japan; COVID-19; Cruise; Coronavirus infection
• DOI: 10.1016/j.jiac.2020.06.010
• ISSN: 1341-321X; 1437-7780

A large COVID-19 outbreak occurred on the cruise ship Diamond Princess in February 2020. Little information has been reported about the clinical characteristics of the patients. This single-center, retrospective, observational study was conducted in Yokohama, Japan. We included symptomatic patients who were infected on the ship and admitted to our hospital between 5 and 19 February 2020. All the cases were confirmed with SARS-CoV-2 infection by polymerase chain reaction (PCR). We confirmed 17 cases. The average age was 69 years; 10 patients were Asian and 7 were Caucasian. Eleven patients had one or more chronic diseases. The major symptoms were cough and fever. Chest computed tomography (CT) scans found bilateral ground-glass opacities predominantly in the peripheral area, which were similar to reports from cases in China. C-reactive protein (CRP) levels were higher in severe and critical cases than in mild to moderate cases. The moderate to severe cases reached symptomatic resolution; one of the three critical cases resulted in death due to multiple organ failure. SARS-CoV-2 was detected by PCR at an average of 7 days after symptomatic resolution. Cough and fever, increased blood CRP levels, and CT findings of bilateral ground-glass opacities predominantly in the peripheral lung were characteristic of the COVID-19 cases in this study. These findings were compatible with those of previous reports.