Analysis of Clinical Characteristics of Patients with Critical COVID-19

Abstract Background: According to the data from the joint investigative team of the WHO and China, the fatality rate in Wuhan is 5.8%and 0.7% in the rest of China. Most of the patients who have died have had chronic diseases or advanced age, and patients with critical COVID-19 have the highest death rate. Patients with critical COVID-19 are the main focus of research on treatment. However, there are few reports on critical COVID-19 patients in China and worldwide. It will help other researchers and clinicians around the world for similar cases.Purpose: Coronavirus disease 2019 (COVID-19) is highly infectious and has a high fatality rate.This paper summarizes and analyses the clinical characteristics of patients with critical COVID-19 to improve clinicians' understanding of this disease. Methods: We selected 16 patients with critical COVID-19 who were treated in the ICU of a grade A hospital in Wuhan from February to March 2020. Then, we collected the clinical data and analysed their general conditions, clinical symptoms, blood tests, CT scans and treatments. Results: Patients with critical COVID-19 had comorbidities (87.5%), and the main symptoms were low or moderate fever (75%), cough and expectoration (68.75%), and multiple lesions in both lungs (100%). 2. Patients with critical COVID-19 were divided into the non-surviving and surviving groups, and the interleukin-6 (IL-6) level and CD4/CD8 ratio were significantly different (P<0.05). 3. On chest CT, multiple patchy lesions were observed in both lungs, mainly as patchy infected lesions, partial consolidation, ground-glass opacities, and interstitial changes. 4. There were 10 patients (62.5%) who survived and 6 (37.5%) who died. Conclusion: Critical COVID-19 is mainly characterized by low or moderate fever, cough and sputum and often occurs in people with chronic disease.Chest CT showed multiple patchy ground-glass opacities and consolidation. For critically ill patients, it is important to monitor interleukin-6 (IL-6) and CD4/CD8 ratio. Early treatment involves thymalfasin, immunoglobulin and other immune-enhancing treatments, and a large dose of ulinastatin can reduce plasma levels of inflammatory factors.