Epidemiology, diagnosis and treatment of early COVID-19 patients in Jiaxing City, Zhejiang Province, China, January to March 2020.

BACKGROUND: Imported Coronavirus disease 2019 (COVID-19) patients pose a huge challenge to the prevention and control of the epidemic in prefecture-level cities in China. However, the treatment strategies at that time were mainly empirical and far from perfect. Hence, this study aims to summarize the clinical characteristics, diagnosis and treatment of all COVID-19 patients in Jiaxing City in 2020. METHODS: The clinical data of 42 patients diagnosed with COVID-19 in Jiaxing City, Zhejiang Province from January 23, 2020 to March 4, 2020 were retrospectively analyzed. Epidemiological history and sociodemographic data were collected. Laboratory parameters, imaging and disease progression, treatment methods, efficacy and adverse reactions of COVID-19 cases were recorded. Then, the clinical characteristics as well as diagnosis and treatment were statistically analyzed. RESULTS: The median age of 42 patients was 47 years old, including 24 males (57.1%) and 18 females (42.9%). There were 21 first-generation cases, 29 cases (69%) of clustering onset related to first-generation cases, and 28 cases without any underlying diseases. Radiographic progression was reported in 17 patients (40.5%) (progression duration, 2-11 days; median progression duration, 3.8 days; average progression duration, 4.59-2.48 days). The main clinical symptoms include fever (78.6%) and cough (64.3%). A total of 37 patients (88.10%) received arbidol combined with lopinavir/ritonavir or darunavir/cobicistat. Of these, 22 patients (52.4%) took a combination with moxifloxacin tablets, and 20 patients (47.6%) took combined hormone therapy. Seventeen patients (40.48%) reported diarrhea, nausea, vomiting, rash, and other adverse drug reactions. A total of 38 patients improved (90.5%). The hospital stays of 36 patients ranged from 7 to 33 days, with a median of 19 days (19.00-7.33 days on average). The virus nucleic acid test result return time was 1 to 32 days, with a median of 15.5 days (14.41-8.61 days on average). CONCLUSIONS: Most of the imported COVID-19 patients in Jiaxing City were of the first generation, mainly cluster onset, and the epidemiological characteristics were relatively simple. Arbidol combined with lopinavir/ritonavir or darunavir/cobicistat was the main treatment strategy for the initial treatment of COVID-19.