Abstract
Background: During the COVID-19 pandemic, many patients admitted to hospital for treatment have recovered and been discharged; however, in some instances, these same patients are re-admitted due to a second fever or a positive COVID-19 PCR test result. To ascertain whether it is necessary to treat these patients in hospitals, especially in asymptomatic cases, we summarize and analyze the clinical and treatment characteristics of patients re-admitted to hospital with a second COVID-19 infection.Methods: Of the 141 COVID-19 cases admitted to the Wenzhou Central Hospital between January 17, 2020, to March 5, 2020, which were followed until March 30, 2020, 12 patients were re-admitted with a second COVID-19 infection. Data was collected and analyzed from their clinical records, lab indexes, commuted tomography (CT), and treatment strategies.Results: Most of the 141 patients had positive outcomes from treatment, with only 12 (8.5%) being re-admitted. In this sub-group: one (8.3%) had a fever, a high white blood cell count (WBC), and progressive CT changes; and one (8.3%) had increased transaminase. The PCR tests of these two patients returned negative results. Another 10 patients were admitted due to a positive PCR test result, seven of which were clinically asymptomatic. Compared to the CT imaging following their initial discharge, the CT imaging of all patients was significantly improved, and none required additional oxygen or mechanical ventilation during their second course of treatment.Conclusions: The prognoses of the re-admitted patients were good with no serious cases. We conclude that home treatment with concentrated medical observation is a safe and feasible course of treatment if the patient returns a positive PCR test result but does not display serious clinical symptoms. During medical observation, patients with underlying conditions should remain a primary focus, but most do not need to be re-admitted to the hospital.
Highlights
On December 8, 2019, a novel pneumonia case was discovered in Wuhan City [1]
Combined with the follow-up and examination results of COVID-19 patients discharged from our hospital, we summarize and analyze the clinical characteristics, treatment options, and prognosis of patients who were re-admitted to the hospital
With advances in the treatments available leading to an increasing number of patients recovering from COVID-19 infections, the management of patients following discharge will become a future focus in handling the pandemic, including the follow-up time, follow-up testing protocols, and at what stage patients can return to normal life
Summary
On December 8, 2019, a novel pneumonia case was discovered in Wuhan City [1]. The first isolation of the coronavirus from a patient suffering from this pneumonia was isolated on January 7, 2020, and was subsequently named COVID-19 by the WHO [2]. On January 17, 2020, Wenzhou confirmed the first new case of COVID-19 pneumonia in Zhejiang Province. From the first COVID-19 patient admitted on January 17, 2020, to March 5, 2020, a total of 141 infected patients were admitted to our hospital. All of these patients recovered and were discharged according to the discharge standards set by the Chinese authorities, and no deaths occurred. During the COVID-19 pandemic, many patients admitted to hospital for treatment have recovered and been discharged; in some instances, these same patients are re-admitted due to a second fever or a positive COVID-19 PCR test result. To ascertain whether it is necessary to treat these patients in hospitals, especially in asymptomatic cases, we summarize and analyze the clinical and treatment characteristics of patients re-admitted to hospital with a second COVID-19 infection
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