Clinical characteristics of 34 COVID-19 patients admitted to ICU in Hangzhou, China

Yi Zheng; Lijun Sun; Mi Xu; Jian Pan; Yuntao Zhang; Xueling Fang; Qiang Fang; Hongliu Cai

The copyright holder for this preprint (which was not peer-reviewed) is the . https://doi.org/10.1101/2020.04.12.20062604 doi: medRxiv preprint than 10 × 10⁹/L, 15 [44.1%] cases) occurred in nearly half of the patients, while, the incidence of leucopenia (white blood cell count less than 4 × 10⁹/L, 2 [5.9%] cases) is very low. Lymphopenia (lymphocyte count < 0.8 × 10⁹/L, 22 [66.4%] patients) occurred in more than half of the patients on admission. Platelet count in NIV group was higher than in IMV group, which were in normal range in most patients of both groups. No significant differences were found between NIV and IMV groups in terms of biochemical indexes, inflammation or immune indicators and coagulation indices on admission to hospital. (Table 2) Only one patient did not receive antiviral and systematic corticosteroid treatment. 30 (88.2%) were given empirical antibiotic treatment, and 27 (79.4%) were given gamma globulin treatment. (7[20.6%]). The complications rates (including, acute liver injury, acute cardiac injury and AKI) were significantly higher and discharge rate was notably lower in IMV cases, compared with NIV patients. (Table 3) Dynamic changes of the main laboratory indicators during COVID-19 progression including blood cells counts and biochemical parameters, coagulation profile and inflammatory cytokines were followed from day 1 to day 9 or discharged day after admission at 1-day interval. White blood cell counts and neutrophil counts were at high levels during hospitalization, and showed declining trends on discharge day in NIV patients. During hospitalization, most patients had marked lymphopenia, and IMV patients developed more severe lymphopenia over time, but lymphocytes returned to normal levels in NIV cases on discharge day. Flow cytometry showed that T lymphocytes counts were further away from the lower normal limit, compared to B lymphocytes in inpatients. T lymphocytes counts stayed low during hospitalization in IMV patients, however, the counts gradually rose to normal level until discharge in a part of NIV patients. Natural killer cells counts in most inpatients were far from the lower normal limit, and the counts progressive declined in IMV cases rather in NIV cases during hospitalization. Platelet counts and hemoglobin levels were higher in NIV cases than those in IMV cases, and hemoglobin levels dropped progressively in IMV cases during hospitalization. C-reactive protein levels in both All rights reserved. No reuse allowed without permission.