Articles dmissionl Cardia All patients(n1)KUcare(n-13) (n-28)pvale ge.years 490(40-580 49-041-0-61.0) 490410575 968 cardiography. tatstcealanehic 8 nancant statsttal a we ng the s and sym 40(98 13(100% 2796 0 14 olecion,dbiaanealsis,dataintepretationorwitng Results /9 88 0(5-0-13 as of an 2.no chilren 5010-80 8050-140 101.0-65 0002 d.Of the 41 patients.13(32% were admitted to the 1250m90-1350) 14501230-167012201185-1295)0018 02 12(29%) 8(62% 44) 00023 infected patients ere diabete D).h pertension (six 15% 66% patients had direct ex eafood s of p sinfectedwith2o19-r 0. with n-ICU care (18 [64%1).T rst patien 2019 for novel irus'Hvo (PaO) logical link was found betwee and classificd on the basis of the hi o admitted hospital ise of a day history of te a 53-vear oma who had no known history of onia ated with pneumonia pathogen from ower respiratory tract spe e The m mmon symptoms at onset of illness wer Articles 500 www.thelancet.com Vol 395 February 15, 2020 for novel coronavirus.9 Hypoxaemia was defined as arterial oxygen tension (PaO₂) over inspiratory oxygen fraction (FIO₂) of less than 300 mm Hg.15 Acute kidney injury was identified and classified on the basis of the highest serum creatinine level or urine output criteria according to the kidney disease improving global outcomes classification.16 Secondary infection was diagnosed if the patients had clinical symptoms or signs of nosocomial pneumonia or bacteraemia, and was combined with a positive culture of a new pathogen from a lower respiratory tract specimen (including the sputum, transtracheal aspirates, or bron￾choalveolar lavage fluid, or from blood samples taken ≥48 h after admission).17 Cardiac injury followed the definition used in our previous study in H7N9 patients.18 In brief, cardiac injury was diagnosed if serum levels of cardiac biomarkers (eg, troponin I) were above the 99th percentile upper reference limit, or new abnormalities were shown in electrocardiography and echocardiography. Statistical analysis Continuous variables were expressed as median (IQR) and compared with the Mann-Whitney U test; categorical variables were expressed as number (%) and compared by χ² test or Fisher’s exact test between ICU care and no ICU care groups. Boxplots were drawn to describe plasma cytokine and chemokine concentrations. A two-sided α of less than 0·05 was considered statis￾tically significant. Statistical analyses were done using the SAS software, version 9.4, unless otherwise indicated. Role of the funding source The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. Results By Jan 2, 2020, 41 admitted hospital patients were identified as laboratory-confirmed 2019-nCoV infection in Wuhan. 20 [49%]) of the 2019-nCoV-infected patients were aged 25–49 years, and 14 (34%) were aged 50–64 years (figure 1A). The median age of the patients was 49·0 years (IQR 41·0–58·0; table 1). In our cohort of the first 41 patients as of Jan 2, no children or adolescents were infected. Of the 41 patients, 13 (32%) were admitted to the ICU because they required high-flow nasal cannula or higher-level oxygen support measures to correct hypox￾aemia. Most of the infected patients were men (30 [73%]); less than half had underlying diseases (13 [32%]), inc￾luding diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). 27 (66%) patients had direct exposure to Huanan seafood market (figure 1B). Market exposure was similar between the patients with ICU care (nine [69%]) and those with non-ICU care (18 [64%]). The symptom onset date of the first patient identified was Dec 1, 2019. None of his family members developed fever or any respiratory symptoms. No epidemiological link was found between the first patient and later cases. The first fatal case, who had continuous exposure to the market, was admitted to hospital because of a 7-day history of fever, cough, and dyspnoea. 5 days after illness onset, his wife, a 53-year-old woman who had no known history of exposure to the market, also presented with pneumonia and was hospitalised in the isolation ward. The most 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 All patients (n=41) ICU care (n=13) No ICU care (n=28) p value Characteristics Age, years 49·0 (41·0–58·0) 49·0 (41·0–61·0) 49·0 (41·0–57·5) 0·60 Sex ·· ·· ·· 0·24 Men 30 (73%) 11 (85%) 19 (68%) ·· Women 11 (27%) 2 (15%) 9 (32%) ·· Huanan seafood market exposure 27 (66%) 9 (69%) 18 (64%) 0·75 Current smoking 3 (7%) 0 3 (11%) 0·31 Any comorbidity 13 (32%) 5 (38%) 8 (29%) 0·53 Diabetes 8 (20%) 1 (8%) 7 (25%) 0·16 Hypertension 6 (15%) 2 (15%) 4 (14%) 0·93 Cardiovascular disease 6 (15%) 3 (23%) 3 (11%) 0·32 Chronic obstructive pulmonary disease 1 (2%) 1 (8%) 0 0·14 Malignancy 1 (2%) 0 1 (4%) 0·49 Chronic liver disease 1 (2%) 0 1 (4%) 0·68 Signs and symptoms Fever 40 (98%) 13 (100%) 27 (96%) 0·68 Highest temperature, °C ·· ·· ·· 0·037 <37·3 1 (2%) 0 1 (4%) ·· 37·3–38·0 8 (20%) 3 (23%) 5 (18%) ·· 38·1–39·0 18 (44%) 7 (54%) 11 (39%) ·· >39·0 14 (34%) 3 (23%) 11 (39%) ·· Cough 31 (76%) 11 (85%) 20 (71%) 0·35 Myalgia or fatigue 18 (44%) 7 (54%) 11 (39%) 0·38 Sputum production 11/39 (28%) 5 (38%) 6/26 (23%) 0·32 Headache 3/38 (8%) 0 3/25 (12%) 0·10 Haemoptysis 2/39 (5%) 1 (8%) 1/26 (4%) 0·46 Diarrhoea 1/38 (3%) 0 1/25 (4%) 0·66 Dyspnoea 22/40 (55%) 12 (92%) 10/27 (37%) 0·0010 Days from illness onset to dyspnoea 8·0 (5·0–13·0) 8·0 (6·0–17·0) 6·5 (2·0–10·0) 0·22 Days from first admission to transfer 5·0 (1·0–8·0) 8·0 (5·0–14·0) 1·0 (1·0–6·5) 0·0023 Systolic pressure, mm Hg 125·0 (119·0–135·0) 145·0 (123·0–167·0) 122·0 (118·5–129·5) 0·018 Respiratory rate >24 breaths per min 12 (29%) 8 (62%) 4 (14%) 0·0023 Data are median (IQR), n (%), or n/N (%), where N is the total number of patients with available data. p values comparing ICU care and no ICU care are from χ² test, Fisher’s exact test, or Mann-Whitney U test. 2019-nCoV=2019 novel coronavirus. ICU=intensive care unit. Table 1: Demographics and baseline characteristics of patients infected with 2019-nCoV