Research on pneumonia exacerbation in patients infected with SARS-CoV-2 in Wuhan, China

Abstract Background SARS-CoV-2 pneumonia occasionally exacerbates to critical condition that is hard to manage. We aim to describe exacerbations of SARS-CoV-2 pneumonia among inpatients. Methods We included confirmed SARS-CoV-2 patients with pneumonia exacerbation admitted to Wuhan Pulmonary Hospital, Hubei Province, China between January 6 and February 17, 2020 and discharged or died before February 25. Their demographic characteristics, clinical symptoms, laboratory tests, CT manifestations, complications and clinical outcomes were collected. Results A total of 158 patients were collected, among them 107 patients were stable and discharged after recovery, 24 patients were already critically severe at hospital admission. 14 patients were excluded for insufficient clinical data. Eventually, 13 confirmed cases were included. The mean age was 65 (± 9.81) years. Ten of the 13 (76.9%) patients were female. Nine (69.2%) had underlying comorbidities. Fever and cough were the most common symptoms (12/13, 92.3%). 10/13(76.9%) patients had their exacerbation in the second week of disease course. All patients had both negative and positive nucleic acid test (NAT) results during the course. Increased range of ground-glass opacity (GGO) on CT imaging are consistent to disease exacerbation. ARDS, MODS, respiratory failure were found in 5/13(38.5%), 3/13(23.1%), 6/13(46.2%) patients respectively. Five (38.5%) patients did not survive. Conclusions SARS-CoV-2 pneumonia exacerbations often occurs in the second week of disease course. Negative NAT result could not exclude exacerbation. CT manifestation is consistent with disease progression. Early admissions have positive effects on reducing complications and mortality.