There is new clinical info available about nCoV and it shows some of the challenges ahead related to clinical care of nCoV. This paper just released describes clinical course in 41 pts with nCoV thelancet.com/pb-assets/Lanc… (1/x) #2019nCov
Some key points from that paper: Of 41 hosp pts in the study, 13 needed the ICU, and 6 died. Of those in the study needing to go to the ICU, only ~1/3 had underlying med condition, broadly defined – e.g. hypertension included as a med condition. (2/x)
Age range 25-64 with median age 49. All had pneumonia on CT scan. In this study, pts who did go on to develop severe resp illness with nCoV have illness that is similar to the severe resp illness seen in SARS. (3/x)
Important to note: still not clear the % of pts w/ nCoV that will get severe illness – need much more dx testing to understand that. This small study that can’t answer that. Need much more Dx testing data + info on clinical course on many more people to determine that. (4/x)
What we do know so far suggests med care for those who develop nCoV severe infxn will be like treating pts w ARDS, w/ some portion requiring mech ventilation. Will need strong infxn control so health care workers are protected. In SARS, hosp care led to a lot of spread. (5/x)
If quarantine efforts are getting in way of Dx testing, or getting hosp supplies in needed to isolate and care for pts, they should be changed or stopped. Diagnosing and isolating people who have nCoV should be highest priority. (6/x)
Will be important to get full info on health care worker infxns that do occur, e.g. what practices were in those settings, what seemed to be cause of infxn. This will help hospitals and health care workers in China and elsewhere in world better protect their staffs. (7/x)
New dedicated facility is being constructed in Wuhan to care for 1,000 nCoV pts. cnhan.com/html/shyw/2020… For new health care facilities in epidemics, its key to ensure they have top med care, or people won’t want to (or agree to) go there when they get sick (8/x)
