Lancet study, Feb 24, 2020
Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study
Xiaobo Yang, MD Yuan Yu, MD Jiqian Xu, MD Prof Huaqing Shu, MD Prof Jia’an Xia, MD Prof Hong Liu, MD et al.
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30079-5/fulltext
Selected quotes, technical data at link (what is lacking is detail on which patients got which antivirals):
The primary outcome was 28-day mortality after ICU admission. Secondary outcomes were incidence of SARS-CoV-2-related acute respiratory distress syndrome (ARDS). ARDS and shock were defined according to the guidance of WHO for novel coronavirus disease 2019 (COVID-19).6 Acute kidney injury was identified on the basis of serum creatinine.11 Cardiac injury was diagnosed if the serum concentration of hypersensitive cardiac troponin I (hsTNI) was above the upper limit of the reference range (>28 pg/mL), measured in the laboratory of Jin Yin-tan Hospital....
We report on 52 critically ill patients with confirmed SARS-CoV-2 infection, characterised by severe hypoxaemia. 32 (61·5%) of critically ill patients had died at 28 days. Of all included patients, 37 (71%) required mechanical ventilation and 35 (67%) had ARDS....
...The fundamental pathophysiology of severe viral pneumonia is severe ARDS. Men and people of an older age (>65 years) are more likely to develop ARDS than women or those of a younger age.16 Therefore, it is reasonable that the mortality at 28 days of severe SARS-CoV-2 pneumonia is similar to the mortality of severe ARDS, which is near 50%.17...
... fever was not detected at the onset of illness in six (11·5%), and that it was in fact detected 2–8 days later. The delay of fever manifestation hinders early identification of patients infected with SARS-CoV-2—if patients are asymptomatic identification of suspected cases is more difficult.19, 20 The median duration from onset of symptoms to radiological confirmation of pneumonia was 5 (3–7) days, meaning that early or repeated radiological examinations are useful in screening patients with SARS-CoV-2 pneumonia.4...
…. we postulate that necrosis or apoptosis of lymphocytes also induces lymphocytopenia in critically ill patients with SARS-CoV-2 infection. In a previous study, mainly in non-critical patients infected with SARS-CoV-2, 35% of patients had only mild lymphocytopenia,2 suggesting that the severity of lymphocytopenia reflects the severity of SARS-CoV-2 infection.
More proof it wrecks t cells.
Feb 24 - Lancet comment (for comments - justifying CCP policy? or applicable to Western societies?)
OVID-19 control in China during mass population movements at New Year
Simiao Chen Juntao Yang Weizhong Yang Chen Wang Till Bärnighausen
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30421-9/fulltext
Social distancing has been effective in past disease epidemics, curbing human-to-human transmission and reducing morbidity and mortality.11, 12, 13, 14, 15, 16, 17 A single social distancing policy can cut epidemic spread, but usually multiple such policies—including more restrictive measures such as isolation and quarantine—are implemented in combination to boost effectiveness. For example, during the 1918–19 influenza pandemic, the New York City Department of Health enforced several social distancing policies at the same time, including staggered business hours, compulsory isolation, and quarantine, which likely led to New York City suffering the lowest death rate from influenza on the eastern seaboard of the USA.17...
….There are several lessons that can be drawn from China’s extension of the Lunar New Year holiday. First, countries facing potential spread of COVID-19, or a similar outbreak in the future, should consider outbreak-control “holidays” or closure periods—ie, periods of recommended or mandatory closure of non-essential workplaces and public institutions—as a first-line social distancing measure to slow the rate of transmission. Second, governments should tailor the design of such outbreak-control closure periods to the specific epidemic characteristics of the novel disease, such as the incubation period and transmission routes. Third, a central goal of an outbreak-control closure period is to prevent people with asymptomatic infections from spreading the disease.