Clinical practice of prevention and treatment of novel coronavirus infection in the medical personnel and surgical patients in the department of thoracic surgery of hospitals in Wuhan_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIANG Wenyang ¹ , XIONG Rui ¹ , LU Zilong ¹ , SHEN Xiaokang ¹ , ZHANG Lin ¹ , TANG Zheng ² , PING Wei ³ , ZHANG Jun ⁴ , KAI Jindan ⁵ , ZHANG Yongjian ⁶ , GAO Wei ⁷ , XING Xin ⁷ , CHEN Xiaobei ⁸ ,  GENG Qing ¹

1. Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, P.R.China;
2. Department of Thoracic and Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, P.R.China;
3. Department of Thoracic Surgery, Tongji Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology,Wuhan, 430030, P.R.China;
4. Department of Thoracic Surgery, Union Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, P.R.China;
5. Department of Thoracic Surgery, Hubei Cancer Hospital, Wuhan, 430070, P.R.China;
6. Department of Thoracic Surgery, Central Hospital of Wuhan, Wuhan, 430014, P.R.China;
7. Department of Cardiothoracic Surgery, Pu Ai Hospital of Wuhan, Wuhan, 430032, P.R.China;
8. Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, 430060, P.R.China;

Corresponding?author：

GENG Qing, Email: szgqing@126.com

Keywords：

Thoracic surgery; novel coronavirus (SARS-CoV-2); novel coronavirus pneumonia (COVID-19); nosocomial infection

DOI：

10.7507/1007-4848.202002117

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the clinical experience in the prevention and treatment of novel coronavirus (2019-nCoV, SARS-CoV-2) disease (COVID-19) in the department of thoracic surgery of large grade A tertiary hospitals in Wuhan, and to provide feasible clinical practice strategies.Methods The clinical data of 41 COVID-19 patients in the department of thoracic surgery of 7 large grade A tertiary hospitals in Wuhan from December 15, 2019 to February 15, 2020 were analyzed retrospectively. There were 20 surgical patients (10 males and 10 females at an average age of 54.35±10.80 years) and 21 medical personnel (7 males and 14 females at an average age of 30.38±6.23 years).Results The main clinical manifestations of COVID-19 patients were fever (70.73%) and cough (53.66%). Normal or reduced peripheral white blood cells and reduced lymphocyte counts were found in the COVID-19 patients, and some patients may have increased C-reactive protein. COVID-19 patients showed limited ground-glass opacities in early chest CT, which was evident in the edge band of lung. The disease could further develop into multiple pulmonary infiltrations, and pulmonary consolidation was found in severe cases. At the time of confirmed diagnosis, most of the medical personnel were ground-glass shadows and unilateral lesions, and even no obvious abnormalities were found in the lungs. The diagnosed COVID-19 patients were transferred to the isolation ward immediately and treated according to the "Diagnosis and Treatment Program of Novel Coronavirus Pneumonia", which was released by the National Health Commission of the People's Republic of China. At the end of follow-up on February 20, 2020, seven surgical patients (35.00%) were discharged and seven (35.00%) were dead, 13 (61.90%) medical personnel were discharged and no death was found.Conclusions Of all COVID-19 patients in the department of thoracic surgery of hospitals in Wuhan, the proportion of severe degree and mortality in surgical patients are significantly higher than that of the general population, and medical personnel are prone to nosocomial infections. Early oxygen therapy and respiratory support may improve prognosis. During the epidemic period of COVID-19, elective or limited surgery is suggested to be postponed and the indications for emergency operation should be strictly controlled. Emergency operation is suggested to be treated in accordance with tertiary prevention. On the consideration of specialty in the department of thoracic surgery, all people of the ward should be carefully investigated for infection once one case is confirmed with COVID-19. Early detection, isolation, diagnosis, and treatment are the best preventive measures to improve the prognosis of COVID-19.

Citation： JIANG Wenyang, XIONG Rui, LU Zilong, SHEN Xiaokang, ZHANG Lin, TANG Zheng, PING Wei, ZHANG Jun, KAI Jindan, ZHANG Yongjian, GAO Wei, XING Xin, CHEN Xiaobei, GENG Qing. Clinical practice of prevention and treatment of novel coronavirus infection in the medical personnel and surgical patients in the department of thoracic surgery of hospitals in Wuhan. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(4): 364-370. doi: 10.7507/1007-4848.202002117 Copy

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1. Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China [published online ahead of print, 2020 Feb 3]. Nature, 2020. doi:10.1038/s41586-020-2008-3.
2. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin [published online ahead of print, 2020 Feb 3]. Nature, 2020. doi:10.1038/s41586-020-2012-7.
3. Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet, 2020, 395(10224): 565-574.
4. 國家衛生健康委辦公廳. 新型冠狀病毒肺炎診療方案 (試行第六版). [2020-2-18]. URL: http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2.shtml.
5. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China [published online ahead of print, 2020 Feb 7]. JAMA, 2020. doi:10.1001/jama.2020.1585.
6. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet. 2020 Jan 30]. Lancet, 2020, 395(10223): 497-506.
7. Liu Y, Yang Y, Zhang C, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury [published online ahead of print, 2020 Feb 9]. Sci China Life Sci, 2020. doi: 10.1007/s11427-020-1643-8.
8. Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV) [published online ahead of print, 2020 Feb 4]. Radiology, 2020. doi:10.1148/radiol.2020200230.
9. Song F, Shi N, Shan F, et al. Emerging coronavirus 2019-nCoV pneumonia [published online ahead of print, 2020 Feb 6]. Radiology, 2020. doi:10.1148/radiol.2020200274.
10. Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China [published online ahead of print, 2020 Feb 13]. Eur Radiol, 2020. doi:10.1007/s00330-020-06731-x.
11. Puybasset L, Cluzel P, Chao N, et al. A computed tomography scan assessment of regional lung volume in acute lung injury. The CT Scan ARDS Study Group. Am J Respir Crit Care Med, 1998, 158(5 Pt 1): 1644-1655.
12. 中國疾病預防控制中心新型冠狀病毒肺炎應急響應機制流行病學組. 新型冠狀病毒肺炎流行病學特征分析. 中華流行病學雜志, 2020, 41(2): 145-151.
13. Tuite AR, Fisman DN. Reporting, epidemic growth, and reproduction numbers for the 2019 novel coronavirus (2019-nCoV) epidemic [published online ahead of print, 2020 Feb 5]. Ann Intern Med, 2020. doi: 10.7326/M20-0358.
14. To KK, Tsang OT, Chik-Yan Yip C, et al. Consistent detection of 2019 novel coronavirus in saliva [published online ahead of print, 2020 Feb 12]. Clin Infect Dis, 2020. doi: 10.1093/cid/ciaa149.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical practice of prevention and treatment of novel coronavirus infection in the medical personnel and surgical patients in the department of thoracic surgery of hospitals in Wuhan

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