Clinical characteristics of the coronavirus disease 2019 (COVID-19) outbreak on a cruise ship

J Infect Chemother. 2020 Nov;26(11):1177-1180. doi: 10.1016/j.jiac.2020.06.010. Epub 2020 Jun 12.

Abstract

Background: A large COVID-19 outbreak occurred on the cruise ship Diamond Princess in February 2020. Little information has been reported about the clinical characteristics of the patients.

Methods: This single-center, retrospective, observational study was conducted in Yokohama, Japan. We included symptomatic patients who were infected on the ship and admitted to our hospital between 5 and 19 February 2020. All the cases were confirmed with SARS-CoV-2 infection by polymerase chain reaction (PCR).

Results: We confirmed 17 cases. The average age was 69 years; 10 patients were Asian and 7 were Caucasian. Eleven patients had one or more chronic diseases. The major symptoms were cough and fever. Chest computed tomography (CT) scans found bilateral ground-glass opacities predominantly in the peripheral area, which were similar to reports from cases in China. C-reactive protein (CRP) levels were higher in severe and critical cases than in mild to moderate cases. The moderate to severe cases reached symptomatic resolution; one of the three critical cases resulted in death due to multiple organ failure. SARS-CoV-2 was detected by PCR at an average of 7 days after symptomatic resolution.

Conclusions: Cough and fever, increased blood CRP levels, and CT findings of bilateral ground-glass opacities predominantly in the peripheral lung were characteristic of the COVID-19 cases in this study. These findings were compatible with those of previous reports.

Keywords: COVID-19; Coronavirus infection; Cruise.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Betacoronavirus / genetics
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / statistics & numerical data
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / virology
  • Disease Outbreaks / statistics & numerical data*
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / virology
  • Polymerase Chain Reaction / statistics & numerical data
  • RNA, Viral / isolation & purification
  • Retrospective Studies
  • SARS-CoV-2
  • Ships / statistics & numerical data*
  • Travel-Related Illness*

Substances

  • RNA, Viral