Clinical features and outcomes of 221 patients with COVID-19 in Wuhan, China

Guqin Zhang; Chang Hu; Linjie Luo; Fang Fang; Yongfeng Chen; Jianguo Li; Zhiyong Peng; Huaqin Pan

The copyright holder for this preprint (which was not peer-reviewed) is the . https://doi.org/10.1101/2020.03.02.20030452 doi: medRxiv preprint improvement of the symptoms and underlying diseases, active prevention of potential complications and secondary infections. Like other viruses, the SARS-CoV-2 enters cells through receptor-mediated endocytosis. 26 Studies showed that the SARS-CoV-2 may infect alveolar epithelial cells in lung through the angiotensin-converting enzyme II (ACE2) receptor, which is also expressed in other tissues, such as kidney, blood vessels and heart. 26 27 Researchers using an artificial intelligence predicted that Baricitinib, an inhibitor of AP2-associated protein kinase 1 (AAK1), might be useful to interrupt the entrance of virus to cells and also the intracellular assembly of the virus particles. 4 28 In addition, a case report showed that remdesivir, an adenosine analogue, has shown survival benefits in one severe COVID-19 pneumonia patient 29 . The effectiveness has been verified in vitro. 30 Now a couple of clinical trials focus on the efficacy of remdesivir, as well as other therapeutic strategies, such as immunoglobulins, Vitamin C infusion, mesenchymal stem cell treatment, arbidol hydrochloride plus interferon atomization, ritonavir combined with oseltamivir, lopinavir plus ritonavir and arbidol hydroxychloroquine and methylprednisolone. 31 The corticosteroid therapy regarding the onset therapeutic time, the dosage, and duration were still controversial in the treatment of severe SARS or SARS-CoV-2 pneumonia. 32 We treated corticosteroid to the patients with refractory high fever, exacerbation of wheezing symptoms, increased interstitial exudation based on chest radiology, and high levels of inflammatory mediators to inhibit the "cytokine storm". Corticosteroid therapy (methylprednisolone 1-2 mg/kg/day) are recommended for severely ill patients with ARDS, for as short a duration of treatment as possible. 33 34 The results showed that the early onset use of corticosteroid may have clinical benefits, but more cases and multivariate correlation analysis regarding the safety and efficacy were needed to verify. Our data also All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity.