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Epidemiologic and Clinical Characteristics of Surgical Patients Infected with COVID-19 in Wuhan
22 Pages Posted: 13 Mar 2020
More...Abstract
Background: Previous studies on the coronavirus disease 2019 (COVID-19) were based on information from intensive care unit in hospital and the general population in Wuhan. But no studies were focus on the epidemiologic and clinical characteristics of COVID-19 in surgical patients. This study aimed to describe the epidemiologic and clinical characteristics of COVID-19 in surgery patients.
Methods: A single-center case series of 1427 hospitalized surgical patients were selected at Renmin Hospital of Wuhan University in Wuhan, China, from January 13 to February 12, 2020. The data was followed up till February 18, 2020. The epidemiological, clinical records, chest CT scans and laboratory results were used for analysis. Outcomes of the epidemiologic and clinical characteristics of surgical patients with diagnosis of COVID-19 pneumonia were compared from first hospital admission to discharge or February 29, 2020. Surgical patients with diagnosis of COVID-19 pneumonia were tracked.
Findings: 14 (0·98%) surgical patients were diagnosed with COVID-19 pneumonia, especially high incidence in thoracic department (3 [10%]), and the median age was 59 years (IQR, 56-74 years). The median time from hospital admission to COVID-19 pneumonia diagnosis was 9.0 days (7·0-12·5 days), and 5.5 days (3·5-7·5 days) from the day of surgery to COVID-19 pneumonia diagnosis. Most surgical patients (10 [71.4%]) suffered pulmonary infection before surgery. Common symptoms were fever (12 [85·7%]) and cough (12 [85·7%]) when diagnosis of COVID-19 pneumonia. The neutrophil/lymphocyte ratio (NLR) was increased after surgery (10·80 [5·70-14·65]) and COVID-19 diagnosis (4·55 [3·79-7·66]) respectively, especially most of (85·7%) NLR were higher (>3·5) than normal when COVID-19 was diagnosed. Chest CT (85·7%) showed bilateral dense shadows or ground glass opacity, and blood CD3+, CD4+ were decreased, but CD4+/CD8+ ratio remained in normal range. COVID-19 surgical patients have long hospital stay and high mortality. 16 medical staffs were infected with COVID-19 pneumonia requiring hospitalization.
Interpretation: In this single-center case series of 1427 surgical patients, the COVID-19 infection rate is 0·98%. middle-aged and eldly patients with preoperative pulmonary infection are more susceptible to COVID-19 infection after surgery. It’s difficult to diagnose and eliminate the suspected surgical patients by chest CT and fever before surgery.
Funding Statement: This study was supported by grants from the National Natural Science Foundation of China (81471844 to Dr Xia), the Fundamental Research Funds for the Central Universities (2042019kf0061).
Declaration of Interests: The authors declare no conflicts of interest.
Ethics Approval Statement: This study was approved by the Medical Ethical Committee of Renmin Hospital of Wuhan University (No. WDRY2020-K024), written informed consent was obtained from each enrolled patient.
Keywords: COVID-19; pneumonia; Surgery; Epidemiology
Suggested Citation: Suggested Citation