Clinical Features, Treatment and Outcomes of 218 Patients with COVID-19: A Retrospective, Multicenter Study Based on Clinical Classification

Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in Wuhan, China in December 2019 and which has subsequently spread worldwide. Methods: Retrospective case series involved 218 confirmed COVID-19 patients who were admitted to three 3A hospitals in Hunan province. To describe the clinical characteristics, laboratory features, treatments and outcomes based on clinical classification in this large group of patients. Findings: The patients were divided into mild cases (10 [5%]), moderate cases (146 [67%]), severe cases (24 [11%]), and critical cases (14 [6%]) according to COVID-19 for clinical classification, and 24 ([11%]) asymptomatic cases were included in the study. Features of the clinical examination most commonly found in these patients were self-reported cough (162 [74%]), fever (145 [67%]), sputum production (99 [45%]), and fatigue (77 [35%]). Common laboratory features included elevated erythrocyte sedimentation rate (66%), C-reaction protein (60%), and lymphopenia (23%). 192 (88%) patients received lopinavir/ritonavir and interferon alpha inhalation, and 196 (90%) patients received Chinese medicine treatment. 25 patients (11%) were admitted to the ICU with or without mechanical ventilation, and 1 patient died. The presence of diabetes (relative risk [RR], 3.0; 95% CI, 1.3-6.8; p=0.007) or other comorbid conditions (RR, 5.9; 95% CI, 1.9-17.8; p=0.002) were independently associated with poor outcome. Interpretation: The clinical classification severity upgrade with age. Most patients are clinically classified as moderate cases. The outcome for the elderly and patients with diabetes, and other chronic underlying diseases is poor. Funding Statement: This study was funded by the Program of Hunan science and technology department (2020SK3011). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study has been approved by the ethics commission of each participating hospital. Written informed consent was waived due to the rapid emergence of this infectious disease.