Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study

QJM. 2020 Sep 1;113(9):657-665. doi: 10.1093/qjmed/hcaa178.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a global pandemic but the follow-up data of discharged patients was barely described.

Aim: To investigate clinical outcomes, distribution of quarantine locations and the infection status of the contacts of COVID-19 patients after discharge.

Design: A prospective cohort study.

Methods: Demographics, baseline characteristics of 131 COVID-19 patients discharged from 3 February 2020 to 21 February 2020 in Wuhan, China were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes, quarantine locations and close contact history were obtained by following up the patients every week up to 4 weeks.

Results: Fifty-three (40.05%) patients on discharge had cough (29.01%), fatigue (7.63%), expectoration (6.11%), chest tightness (6.11%), dyspnea (3.82%), chest pain (3.05%) and palpitation (1.53%). These symptoms constantly declined in 4 weeks post-discharge. Transient fever recurred in 11 (8.4%) patients. Among the discharged patients, 78 (59.5%) underwent chest CT and 2 (1.53%) showed deterioration. A total of 94 (71.8%) patients received SARS-CoV-2 retest and 8 (6.10%) reported positive. Seven (2.29%) patients were readmitted because of fever or positive SARS-CoV-2 retest. After discharge, 121 (92.37%) and 4 (3.05%) patients were self-quarantined at home or community spots, respectively, after a close contact with 167 persons in total who were free of COVID-19 at the endpoint of study.

Conclusion: The majority of COVID-19 patients after discharge were in the course of recovery. Readmission was required in rare cases due to suspected recurrence of COVID-19. Although no contacted infection observed, appropriate self-quarantine and regular re-examination are necessary, particularly for those who have recurred symptoms.

MeSH terms

  • Aftercare
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • China / epidemiology
  • Contact Tracing / methods*
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / therapy
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Pandemics*
  • Patient Discharge Summaries / statistics & numerical data*
  • Patient Readmission / statistics & numerical data
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / therapy
  • Quarantine* / methods
  • Quarantine* / statistics & numerical data
  • Retreatment / statistics & numerical data
  • SARS-CoV-2
  • Symptom Assessment / statistics & numerical data
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / statistics & numerical data