Articles Clinical features of patients infected with 2019 novel )@圆 coronavirus in Wuhan,China ears heng Gos ungang Xie Summary enet2020,395497-506 stic 0-6736(2030183 d to a sequencing Data were obtained with standardised data forms shared by WHO and th 2020m record 470 v-confirmed 20 induding diabe t0n1 and ular dise (six 115 patients had be posed【G Huanan seafood et.One family c e we (1 s(two%]of 3).and diarr oea (one ]of 38).Dyspnoead eveloped in 22 (55%)of 40 pat (me uded ac pe 1229 %.13329%)p阳tien ofUL2 U.U10.GSCE IP10.MCPL MIPLA n TNE with non-ICU patients,ICU patients h etation The ICU admission and high mortality.Major s in our knowlede henga,epidemiolbgyduaionofhumantnnsmiksion,andinicalspecumofdistehelRihlnealbyfug ence an Copyright C)2020 Elsevier Ltd.All rights reserved. Introduction potentially more novel and severe zoonotic events to be ruses are enveloped nor segmented positive revealed. humans and other mammals. with clinical presentations greatly esembling viral the two betacoroni cute (SARS-CoV MER Mid which was named 2019 novel coronavirus(2019-nCoV) ases in the y other and the USA and in ThailArticles www.thelancet.com Vol 395 February 15, 2020 497 Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China Chaolin Huang*, Yeming Wang*, Xingwang Li*, Lili Ren*, Jianping Zhao*, Yi Hu*, Li Zhang, Guohui Fan, Jiuyang Xu, Xiaoying Gu, Zhenshun Cheng, Ting Yu, Jiaan Xia, Yuan Wei, Wenjuan Wu, Xuelei Xie, Wen Yin, Hui Li, Min Liu, Yan Xiao, Hong Gao, Li Guo, Jungang Xie, Guangfa Wang, Rongmeng Jiang, Zhancheng Gao, Qi Jin, Jianwei Wang†, Bin Cao† Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission. Copyright © 2020 Elsevier Ltd. All rights reserved. Introduction Coronaviruses are enveloped non-segmented positive￾sense RNA viruses belonging to the family Coronaviridae and the order Nidovirales and broadly distributed in humans and other mammals.1 Although most human coronavirus infections are mild, the epidemics of the two betacoronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV) 2–4 and Middle East respiratory syndrome coronavirus (MERS-CoV),5,6 have caused more than 10 000 cumulative cases in the past two decades, with mortality rates of 10% for SARS-CoV and 37% for MERS-CoV.7,8 The coronaviruses already identified might only be the tip of the iceberg, with potentially more novel and severe zoonotic events to be revealed. In December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China, with clinical presentations greatly resembling viral pneumonia.9 Deep sequencing analysis from lower respiratory tract samples indicated a novel coronavirus, which was named 2019 novel coronavirus (2019-nCoV). Thus far, more than 800 confirmed cases, including in health-care workers, have been identified in Wuhan, and several exported cases have been confirmed in other provinces in China, and in Thailand, Japan, South Korea, and the USA.10–13 Lancet 2020; 395: 497–506 Published Online January 24, 2020 https://doi.org/10.1016/ S0140-6736(20)30183-5 This online publication has been corrected. The corrected version first appeared at thelancet.com on January 30, 2020 See Comment pages 469 and 470 *Contributed equally †Joint corresponding authors Jin Yin-tan Hospital, Wuhan, China (Prof C Huang MD, Prof L Zhang MD, T Yu MD, J Xia MD, Y Wei MD, Prof W Wu MD, Prof X Xie MD); Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases (Y Wang MD, G Fan MS, X Gu PhD, H Li MD, Prof B Cao MD), Institute of Clinical Medical Sciences (G Fan, X Gu), and Department of Radiology (M Liu MD), China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Y Wang, G Fan, X Gu, H Li, Prof B Cao); Department of Respiratory Medicine, Capital Medical University, Beijing, China (Y Wang, H Li, Prof B Cao); Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China (Prof X Li MD, Prof R Jiang MD); NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology (Prof L Ren PhD, Y Xiao MS, Prof L Guo PhD, Q Jin PhD, Prof J Wang PhD), and Institute of Laboratory Animal Science (Prof H Gao PhD), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Tongji Hospital (Prof J Zhao MD, Prof J Xie MD), and Department