Study on clinical characteristics of 173 cases of COVID-19 and effect of glucocorticoid on nucleic acid negative conversion.

Fu, Enqing; Ma, Ruina; Wang, Linxu; Fu, Han; Li, Wangping

Objective: To study the clinical characteristics, changes in relevant test parameters, time of nucleic acid negative conversion, and effect of glucocorticoid treatment in Wuhan area patients with the novel coronavirus pneumonia (COVID-19). Methods: Data of 173 inpatients at Huoshenshan Hospital from February 10 to March 17, 2020, were analyzed retrospectively. Clinical characteristics, partial test results, and the influence of glucocorticoid therapy on the clinical outcomes of nucleic acid negative conversion and changes in lung CT images were compared. The patients were divided at admission into 4 groups according to the course of disease and glucocorticoid treatment. Differences among the groups were analyzed statistically. Results: The median age of 173 patients was 62 years, and 91.3% were over 40 years old. Underlying diseases occurred in 50.3% of patients, 32.6% had family gatherings, and 24.3% had exposure while shopping or at a hospital. Median times of nucleic acid negative conversion in group A+B (course of disease < 3 weeks) and group C+D (course of disease ≥ 3 weeks) were 23 days and 37 days, respectively (P < 0.05). Other group comparisons, i.e., of A+C with B+D, A with B, or C with D, were not statistically different. One week after reexamination, chest CT lesion area had changed by 52% in group C and 50% in group D (P > 0.05). In some patients, administration of glucocorticoid for more than 4 weeks significantly promoted the reduction of inflammatory shadow in the lung. Conclusion: Most patients hospitalized with COVID-19 in Wuhan were middle-aged and elderly people with underlying diseases and a history of family gatherings. Glucocorticoid therapy did not affect nor prolong the duration of nucleic acid negative conversion. Glucocorticoid therapy could promote improvement of lung lesions within 3 weeks after disease onset. Beyond 3 weeks, the treatment did not promote reduction in lung shadow area, however the density of shadow did decrease.