The new coronavirus has been a fight against the unknown for all doctors. There are many questions as how does it attack the body? What are the symptoms? Who is likely to be seriously ill? What is the treatment?

An account by medics on the front line of this epidemic, at the Jinyintan Hospital, in Wuhan, has provided answers. A comprehensive analysis of the first 99 patients treated there has been published in the Lancet medical journal.

Lung assault

All of the 99 patients taken to the hospital had pneumonia and their lungs were inflamed and the tiny sacs where oxygen moves from the air to the blood were filled with water.

Other symptoms were: fever, cough, shortness of breath, muscle aches, confusion, headache, sore throat

First deaths

The first two patients who died were apparently healthy, though they were long-term smokers and would have weakened their lungs.

The first, a 61-year-old man, had severe pneumonia when he came to the hospital. He was in acute respiratory distress, his lungs were unable to provide enough oxygen to his organs to keep his body alive. Despite being on a ventilator, his lungs failed and his heart stopped beating. He died 11 days later.

The second patient, a 69-year-old man, also had acute respiratory distress syndrome. He was attached to an artificial lung or ECMO (extra-corporeal membrane oxygenation) machine. He died of severe pneumonia and septic shock when his blood pressure collapsed.

As of 25 January 2020, of the 99 patients:

• 57 were still in hospital
• 31 had been discharged
• 11 had died

Market workers

Live animals sold at the Huanan seafood market are assumed to be the source of the infection, called 2019-nCoV. 49 out of the 99 patients had a direct connection to the market. 47 worked there, either as managers or managing the stall and two were shoppers who had just visited.

Middle-aged men are worst affected

Most of the 99 patients were middle-aged men with an average age of 56 and 67 years. The China Centers for Disease Control and Prevention said 1.2 men were infected for every 1.0 women.

Two possible explanations for the difference:

• Men are more likely to become severely ill and need hospital treatment.Men, for social or cultural reasons, might be more likely to be exposed to the virus at the beginning of the outbreak.
• Dr Li Zhang, at the hospital, said that the reduced susceptibility of females to viral infections could be attributed to the protection from X chromosome and sex hormones, which play an important role in immunity.

Those who were already sick

Most of the 99 had other diseases that might have made them more susceptible to the virus as a "result of the weaker immune functions of these patients".

• 40 had a weak heart or damaged blood vessels due to conditions such as heart disease, heart failure and stroke
• 12 patients had diabetes

Source: BBC News