Chinese Virus

Chinese Virus www.infralive.com 46 Infra LIVE April 15, 2020 or serum creatinine. Regarding the infection index, procalcitonin was above the normal range in six (6 pc) patients. Most patients had serum ferritin above the normal range. 73 patients were tested for C-reactive protein, most of whom had levels above the normal range. According to chest x-ray and CT, 74 (75 pc) patients showed bilateral pneumonia (75 pc) with just 25 (25 pc) patients showing unilateral pneumonia. 14 (14 pc) patients showed multiple mot- tling and ground-glass opacity. Additionally, pneumothorax occurred in one (1 pc) patient. Case 1: chest x-ray was obtained on Jan 1 (1A). The brightness of b o t h l u n g s w a s d i f f u s e l y decreased, showing a large area of patchy shadow with uneven density. Tracheal intubation was seen in the trachea and the heart shadow outline was not clear. The catheter shadow was seen from t h e r i g h t a x i l l a t o t h e mediastinum. Bilateral diaphrag- matic surface and costal dia- phragmatic angle were not clear, and chest x-ray on Jan 2 showed worse status (1B). Case 2: chest x-ray obtained on Jan 6 (2A). The brightness of both lungs was decreased and multiple patchy shadows were observed; edges were blurred, and large ground-glass opacity and conden- sation shadows were mainly on the lower right lobe. Tracheal intubation could be seen in the trachea. Heart shadow roughly presents in the normal range. On the left side, the diaphragmatic surface is not clearly displayed. The right side of the diaphrag- matic surface was light and smooth and rib phrenic angle was less sharp. Chest x-ray on Jan 10 showedworse status (2B). Case 3: chest CT obtained on Jan 1 (3A) showed mass shadows of high density in both lungs. Bright bronchogram is seen in the lung tissue area of the lesion, which is possible causative bacteria or fungi. Additionally, all patients were given chest x-rays or chest CT. On admission, most patients had fever or cough and a third of patients had shortness of breath. Other symptoms included muscle ache, headache, confusion, chest pa i n , and d i ar rhoea . Many patients presented with organ function damage, including 17 (17 pc) with ARDS, eight (8 pc) with acute respiratory injury, three (3 pc) with acute renal injury, four (4 pc) with septic shock, and one (1 pc) with ventilator-associated pneumonia. Clinical characteristics and treatment of patients with 2019- nCoVpneumonia ARDS=a c u t e r e s p i r a t o r y d i s t r e s s s y n d r o m e . ECMO=extracorporeal mem- b r a n e o x y g e n a t i o n . CRRT=continuous renal replace- ment therapy. On admission, leucocytes were below the normal range in nine (9 pc) patients and above the normal range in 24 (24 pc) patients. 38 (38 pc) patients had neutrophils above the normal range. Lympho- cytes and haemoglobin were below the normal range in many patients. Platelets were below the normal range in 12 (12 pc) patients and above the normal range in four (4 pc). 43 patients had differing degrees of liver function a bno rma l i t y , w i t h a l an i n e ami no t r ans f e r as e (ALT) or aspartate aminotransferase (AST) above the normal range; one patient had severe liver function damage (ALT 7590 U/L, AST 1445 U/L). Most patients had abnormal myocardial zymogram, which showed the elevation of creatine kinase in 13 (13 pc) patients and t h e e l e v a t i o n o f l a c t a t e dehydrogenase in 75 (76 pc) patients, one of whom also showed abnormal creatine kinase ( 6 2 8 0 U / L ) a n d l a c t a t e dehydrogenase (20 740 U/L). Seven (7 pc) patients had different degrees of renal function damage, with elevated blood urea nitrogen medical insurance inChina. A t p r e s en t , i n f o rma t i on regarding the epidemiology and clinical features of pneumonia caused by 2019-nCoV is scarce. In this study, we did a compre- hens i ve exp l ora t i on o f the e p i d emi o l o g y and c l i n i c a l features of 99 patients with confirmed 2019-nCoV pneumo- nia admitted to Jinyintan Hospi- tal, Wuhan, which admitted the first patients with 2019-nCoV to be reported on. Procedures We obtained epidemiological, demographic, clinical, laboratory, management, and outcome data from patients' medical records. Clinical outcomes were followed up to Jan 25, 2020. If data were missing from the records or clarification was needed, we obtained data by direct communi- cation with attending doctors and other health-care providers. All data were checked by two physi- cians (XDandYQ). Laboratory confirmation of 2019-nCoV was done in four different institutions: the Chinese CDC, the Chinese Academy of Medical Science, Academy of Military Medical Sciences, and Wuhan Institute of Virology, Chinese Academy of Sciences. Throat-swab specimens from the upper respiratory tract that were obtained from all patients at admission were maintained in viral-transport medium. 2019- nCoV was confirmed by real-time RT-PCR using the same protocol described previously. RT-PCR detection reagents were provided by the four institu- tions. Other respiratory viruses including influenza A virus (H1N1, H3N2, H7N9), influenza B virus, respiratory syncytial virus, parainfluenza virus, adenovirus, SARS coronavirus (SARS-CoV), and MERS coronavirus (MERS- CoV) were also examined with real-timeRT-PCR Spu t um o r endo t r a che a l asp i ra t es were obt a ined a t admission for identification of