AUTHOR=Chen Sheng-long , Feng Hui-ying , Xu Hui , Huang Shan-shan , Sun Jiu-feng , Zhou Lin , He Jun-lei , Song Wen-liang , Wang Rui-jie , Li Xin , Fang Ming 

TITLE=Patterns of Deterioration in Moderate Patients With COVID-19 From Jan 2020 to Mar 2020: A Multi-Center, Retrospective Cohort Study in China

JOURNAL=Frontiers in Medicine

VOLUME=Volume 7 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.567296

DOI=10.3389/fmed.2020.567296

ISSN=2296-858X

ABSTRACT=Background: Around the globe, moderate cases account for the largest proportion of all COVID-19 patients, and deteriorated moderate patients contribute the most in mortality. However, published articles failed to address the deterioration details of moderate case, especially on when and how they deteriorated.
Methods: All moderate COVID-19 patients hospitalized in Guangdong Province from Jan 14th to Mar 16th, 2020 were included in this multi-centre, retrospective, cohort study, and were divided into deteriorated and non-deteriorated groups according to clinical status. Demography, symptoms, therapy and laboratory characteristics were collected to explore the features of disease deterioration. 
Results: Of 1168 moderate patients included, 148 (13%) deteriorated to severe (130 cases) or critical (18 cases) status. Over 20% of the older subgroup (＞50 years old) showed deterioration. The median time for deterioration was 11 days after onset (IQR 9-14). 12.2% severe cases could further develop to critical status after 3 days (IQR 2-6.5) of having severe condition. Respiratory dysfunction and hypoxia were the major manifestations as disease deterioration, while 76 cases (52.1%) showed respiratory rate >30 breaths/min, 119 cases (80.4%) showed SaO2<93%, 100 cases (67.5%) had 201