Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510060, China.
Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510060, China.
J Clin Virol. 2020 Dec;133:104661. doi: 10.1016/j.jcv.2020.104661. Epub 2020 Oct 14.
Coronavirus Disease 2019 (COVID-19) is threatening billions of people. We described the clinical characteristics and explore virological and immunological factors associated with clinical outcomes.
297 COVID-19 patients hospitalized in Guangzhou Eighth People's Hospital between January 20 and February 20, 2020 were included. Epidemiological, clinical and laboratory data were collected and analyzed. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in respiratory tract, blood samples and digestive tract was detected and lymphocyte subsets were tested periodically.
Among the 297 patients (median age of 48 years), 154 (51.9 %) were female, 245 (82.5 %) mild/moderate cases, and 52 (17.5 %) severe/critical cases. 270 patients were detected for SARS-CoV-2 RNA in anal swabs and/or blood samples, and the overall positive rate was 23.0 % (62/270), higher in severe/critical cases than in mild/moderate cases (52.0 % vs. 16.4 %, P < 0.001). The CD4/CD8 ratio on admission was significantly higher in severe/critical cases than in mild/moderate cases (1.84 vs. 1.50, P = 0.022). During a median follow-up period of 17 days, 36 (12.1 %) patients were admitted to intensive care unit (ICU), 16 (5.4 %) patients developed respiratory failure and underwent mechanical ventilation, four (1.3 %) patients needed extracorporeal membrane oxygenation (ECMO), only one (0.34 %) patients died of multiple organ failure. Detectable SARS-CoV-2 RNA in anal swabs and/or blood samples, as well as higher CD4/CD8 ratio were independent risk factors of respiratory failure and ICU admission.
Most of COVID-19 patients in Guangzhou are mild/moderate, and presence of extrapulmonary virus and higher CD4/CD8 ratio are associated with higher risk of worse outcomes.
2019 年冠状病毒病（COVID-19）正在威胁着数十亿人。我们描述了临床特征，并探讨了与临床结局相关的病毒学和免疫学因素。
纳入 2020 年 1 月 20 日至 2 月 20 日期间在广州市第八人民医院住院的 297 例 COVID-19 患者。收集并分析了流行病学、临床和实验室数据。定期检测呼吸道、血液样本和消化道中的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）RNA 和淋巴细胞亚群。
在 297 例患者中（中位年龄 48 岁），154 例（51.9%）为女性，245 例（82.5%）为轻症/中度病例，52 例（17.5%）为重症/危重症病例。270 例患者检测了肛拭子和/或血液样本中的 SARS-CoV-2 RNA，总阳性率为 23.0%（62/270），重症/危重症病例中阳性率高于轻症/中度病例（52.0%比 16.4%，P<0.001）。重症/危重症病例入院时 CD4/CD8 比值明显高于轻症/中度病例（1.84 比 1.50，P=0.022）。中位随访 17 天期间，36 例（12.1%）患者入住重症监护病房（ICU），16 例（5.4%）患者发生呼吸衰竭并接受机械通气，4 例（1.3%）患者需要体外膜氧合（ECMO），仅有 1 例（0.34%）患者死于多器官功能衰竭。肛拭子和/或血液样本中可检测到 SARS-CoV-2 RNA 以及较高的 CD4/CD8 比值是发生呼吸衰竭和入住 ICU 的独立危险因素。
广州的 COVID-19 患者多数为轻症/中度，肺外病毒存在及较高的 CD4/CD8 比值与不良结局风险增加相关。
