Clinical Course and Virus Shedding of Mild and Moderate COVID-19 in South China: A Retrospective Study

Haiyan Guo1#, Qianhong Zhong2#, Aizhen Chen3, Guoqiang Chen4 and Zhilong Wu2*

1The Seventh Affiliated Hospital of Sun Yat-sen University, Guangdong Province, China
2The Fourth People's Hospital of Foshan City, Guangdong Province, China
3Center for Disease Control and Prevention of Foshan City, Guangdong Province, China
4The First People's Hospital of Foshan City, Guangdong Province, China
#These authors contributed equally to this work

^*Correspondance to: Zhilong Wu 

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Abstract:

Background: Among patients with Coronavirus pneumonia (COVID-19), those with mild-tomoderate diseases often have nonspecific features leading to delay in diagnosis and spreading of the infection. We studied patients with mild-to-moderate diseases to identify clinical, radiological and laboratory features that will facilitate early diagnosis. Methods: This is a retrospective study of COVID-19 patients with mild-to-moderate severity who were admitted to two designated hospitals in Foshan City, Guangdong Province and discharged from January 24th, 2020 to March 10th, 2020. Demographic data, clinical features, laboratory chest CT findings, and virus shedding were collected. Results: A total of 70 mid-to-moderate COVID-19 patients (52.9% male, mean age 40.9 ± 14.6 years) were enrolled; 52.9% were clustered cases. The average age of patients with mild symptoms was younger than those with moderate symptoms (27.0 ± 5.2 vs. 42.2 ± 14.5, P<0.01). Median incubation period was 5.0 (Interquartile IQR: 2.0-10.8) days. The average temperature of all patients during the first 3 days was low-grade fever. Dyspnea is uncommon (5.3%). Lactate Dehydrogenase (LDH) was elevated (456.5 ± 174.4 U/L) and serum Ca2+ was lowered [1.1 (IQR: 1.1-2.2) mmol/l] in all patients. Leukocyte count was normal in all patients. Chest CT abnormalities including ground glass opacification, vascular thickening, mixed lesions and consolidation were observed in 98.4%, 81.3%, 59.4%, and 6.3% of patients with moderate diseases. The worst chest CT lesions were observed at Day 10. All the COVID-19 patients had a high viral load within 11 days. The average time of nucleic acid conversion was 17.4 ± 8.2 days, with one case prolonged up to 55 days. Conclusion: Our study revealed that low grade fever, elevated LDH, lowered calcium levels, and abnormal chest CT findings were common features in patients with mild-to-moderate COVID-19 in South China. In contrast, dyspnea was uncommon and none had abnormal leukocyte count. These findings provide important clues for clinicians to make an early diagnosis.

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Cite the Article:

Guo H, Zhong Q, Chen A, Chen G, Wu Z. Clinical Course and Virus Shedding of Mild and Moderate COVID-19 in South China: A Retrospective Study. Ann Clin Case Rep. 2022; 7: 2264.