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Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19

Journal of Korean Medical Science 2020년 35권 13호 p.142 ~ 142
김의석 ( Kim Eu-Suk ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine

진범식 ( Chin Bum-Sik ) - National Medical Center Department of Internal Medicine
강창경 ( Kang Chang-Kyung ) - Seoul National University College of Medicine Department of Internal Medicine
김남중 ( Kim Nam-Joong ) - Seoul National University College of Medicine Department of Internal Medicine
강유민 ( Kang Yu-Min ) - Myongji Hospital Department of Infectious Diseases
최재필 ( Choi Jae-Phil ) - Seoul Medical Center Department of Internal Medicine
오동현 ( Oh Dong-Hyun ) - Seoul Medical Center Department of Internal Medicine
김정한 ( Kim Jeong-Han ) - Armed Forces Capital Hospital Department of Internal Medicine
고보람 ( Koh Bo-Ram ) - Gyeonggi Provincial Medical Center Ansung Hospital Department of Internal Medicine
김성은 ( Kim Seong-Eun ) - Chonnam National University Medical School Department of Infectious Diseases
윤나라 ( Yun Na-Ra ) - Chosun University College of Medicine Department of Internal Medicine
이재훈 ( Lee Jae-Hoon ) - Wonkwang University School of Medicine Department of Internal Medicine
김진용 ( Kim Jin-Yong ) - Incheon Medical Center Department of Internal Medicine
김연재 ( Kim Yeon-Jae ) - National Medical Center Department of Internal Medicine
방지환 ( Bang Ji-Hwan ) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Division of Infectious Diseases
송경호 ( Song Kyoung-Ho ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
김홍빈 ( Kim Hong-Bin ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
 ( Chung Ki-Hyun ) - National Medical Center Department of Pediatrics
오명돈 ( Oh Myoung-Don ) - Seoul National University College of Medicine Department of Internal Medicine

Abstract


Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea.

Methods: All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness.

Results: The median age was 40 years (range, 20?73 years) and 15 (53.6%) patients were male. The most common symptoms were cough (28.6%) and sore throat (28.6%), followed by fever (25.0%). Diarrhea was not common (10.7%). Two patients had no symptoms. Initial chest X-ray (CXR) showed infiltration in 46.4% of the patients, but computed tomography scan confirmed pneumonia in 88.9% (16/18) of the patients. Six patients (21.4%) required supplemental oxygen therapy, but no one needed mechanical ventilation. Lymphopenia was more common in severe cases. Higher level of C-reactive protein and worsening of chest radiographic score was observed during the 5?7 day period after symptom onset. Viral shedding was high from day 1 of illness, especially from the upper respiratory tract (URT).

Conclusion: The prodromal symptoms of COVID-19 were mild and most patients did not have limitations of daily activity. Viral shedding from URT was high from the prodromal phase. Radiological pneumonia was common from the early days of illness, but it was frequently not evident in simple CXR. These findings could be plausible explanations for the easy and rapid spread of SARS-CoV-2 in the community.

키워드

COVID-19; SARS-CoV-2; Viral Pneumonia; Prognosis; Cohort Study; Republic of Korea
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