Follow-Up Study of 131 COVID-19 Discharged Patients: Is the Current Chinese Discharge Criteria Reliable?

Background: The outbreak of COVID-19 is a global concern. Positive 2019-nCoV nucleic acid results were reported in discharged patients, arousing the question of the reliability of current Chinese discharge criteria. To explore this issue, and to track the clinical outcomes of discharged COVID-19 patients, we took the lead in following up COVID-19 discharged patients. Methods: 131 COVID-19 patients who met current discharged criteria were followed up to 2-3 weeks. Demographics, baseline characteristics including onset and discharged symptoms, disease course,length of hospital stay, severity, and laboratory tests of the patients were obtained. Post-hospitalization data consisted of symptoms, treatments, laboratory and radiological outcomes, quarantine locations and close contact history were collected. Findings: The median age of the discharged COVID-19 was 49, with the leading comorbidity and onset symptom of hypertension and fever. The incidence of symptoms including chest tightness (3.82%), dyspnea (3.05%), cough (2.29%), fatigue (0.76%), expectoration (0.76%), chest pain (0.76%) palpitation (0.76%), nausea (0.76%), were constantly declined in two weeks of follow-up as compared to those at discharge. Fever (2.29%) and headache (0.76%) newly occurred. During the first week, only 8 discharged patients underwent chest CT, with 6 non-deteriorated. 8 received 2019-nCoV test, with 4 positive. And 4 underwent complete blood count (CBC), with all 4 normal. Patients were more engaged in reexmination in the second week, with increased negative 2019-nCoV, normal CBC and improved CT. Post-discharge treatments were mainly anti-symptomatic medicines. 88.55% of the patients were quarantined at home, with 109 closely contacted persons free of COVID-19. All of 5 recurred positive 2019-nCoV patients were asymptomatic associating with negative laboratory tests and improved CT after appropriate management. Interpretation: Discharged COVID-19 patients were overally associated with satisfied recovery, confirmed by the alleviated symptoms, improved laboratory tests and radiological assessment. Based on the current criteria of discharge, no contacted infection was observed. Stringent quarantine with standard clinical reexamination in an extended period is highly recommended for the discharged COVID-19 patients. Funding Statement: National Natural Science Foundation of China (NO. 81800095) Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (TJ-IRB20200217). Considering COVID-19 is an emerging infectious disease and this study is non-interventional, written informed consent was waived by the Ethics Commission of the designated hospital.