Editor's note: The Paper immediately deleted this article.
Source: The Paper News, Reporter Wen Xiaoxiao, Liao Yan, Tang Qi
On March 4th, Ms. Mei from Qiaokou District, Wuhan, reported to The Paper News that her husband, Mr. Li Liang, 36 years old, was diagnosed with COVID-19. After treatment, he was discharged from the cabin hospital on February 26th and was sent to a designated hotel for recovery and isolation. On March 2nd, he suddenly fell ill at the recovery site and passed away after being sent to the hospital.
According to the medical certificate of resident death issued by the Wuhan Municipal Health Commission provided by Ms. Mei, the direct cause of Li Liang's death was COVID-19, and the disease or condition that caused the death was sudden death due to respiratory obstruction and respiratory circulatory failure.
Li Liang's death certificate, all images in this article are provided by the family
The discharge certificate issued by the Han Yang Cabin Hospital on February 26th shows that Li Liang was admitted to the Han Yang Cabin Hospital on February 12th. After standardized treatment and consultation by an expert group, he met the discharge criteria for COVID-19 patients and was allowed to be discharged. The discharge certificate reminds: after discharge, please isolate yourself in a single room in the community for 14 days. If you feel unwell, please contact the community leader immediately and go to the designated hospital if necessary.
Ms. Mei said that the recovery site where Li Liang was isolated and observed after discharge was the Vienna Hotel on Hanxi San Road, Qiaokou District, Wuhan. She said that a day or two after checking in, her husband said his mouth was dry and his stomach was a little bloated. On the morning of March 2nd, she had a video chat with her husband again. Her husband said he didn't want to eat, lay in bed without strength, couldn't even stand up, and quickly hung up the phone. Ms. Mei was very worried and couldn't reach her husband by phone anymore. In a hurry, she called the front desk of the isolation hotel, and the staff at the front desk told her not to worry.
According to Ms. Mei, at around 10 o'clock in the morning on March 2nd, Mr. Li answered her video call again, and at that time the doctor happened to be doing rounds. The doctor told her that Mr. Li might be under a lot of mental stress.
Ms. Mei said that later, her husband was taken to the nearest hospital by an ambulance, and her husband passed away at 5:08 pm that day.
A staff member surnamed Ma from the aforementioned hotel recovery site told The Paper News that Li Liang checked into the recovery site at 4:37 pm on February 26th. More than ten other people who were discharged from the Han Yang Cabin Hospital also checked into the recovery site. Currently, no similar sudden situations have occurred among the remaining individuals.
Li Liang's discharge certificate
Li Liang's discharge summary
According to multiple written materials provided by Ms. Mei, her husband Li Liang's CT report on February 4th showed "bilateral lung infection, suspected viral pneumonia". After treatment, the CT report on February 23rd showed "scattered multiple density increased shadows in both lungs, mostly ground-glass density, some grid-like changes, mostly located under the pleura, small nodules in the lower lobes of both lungs, with a maximum diameter of 0.4 cm, follow-up examination recommended". The discharge summary on February 25th showed that after symptomatic supportive treatment, Li Liang had a normal body temperature for more than 3 days, respiratory symptoms significantly improved, two consecutive negative nucleic acid tests, no oxygen saturation greater than 95% was required, the course of the disease exceeded 14 days, and after evaluation by the expert group, he was allowed to be discharged.
According to a report by China National Radio, on February 22nd, Wuhan issued a notice on the implementation of rehabilitation isolation for cured and discharged COVID-19 patients, requiring discharged patients to undergo a 14-day free rehabilitation isolation and medical observation at designated locations. After the observation period, if the patient's physical condition meets the requirements, the isolation can be lifted.
On March 4th, the National Health Commission released the latest version of the "Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7)". In response to the issue of a small number of discharged COVID-19 patients testing positive again in nucleic acid tests, the new version of the protocol adjusted the post-discharge precautions from "should continue to monitor their own health for 14 days" to "should continue to undergo 14 days of isolation management and health monitoring".
The phenomenon of patients testing positive again after discharge has attracted attention. On the afternoon of February 28th, at a press conference of the Joint Prevention and Control Mechanism of the State Council, Guo Yanhong, Commissioner of the Medical Administration and Medical Management Bureau of the National Health Commission, introduced that some provinces reported cases of cured and discharged patients testing positive again in nucleic acid tests. Through monitoring, it was found that these patients did not transmit the virus to others again, and some patients tested negative for the novel coronavirus again.
Guo Yanhong said that the novel coronavirus is a new virus, and its pathogenesis, the overall picture of the disease, and the characteristics of the course of the disease still need to be further understood. Therefore, on the one hand, we need to further strengthen the management of discharged patients and require 14 days of medical observation. At the same time, we will organize experts to further study this situation and deepen our understanding of the entire process of the occurrence, development, and outcome of the disease.
Regarding this issue, on February 27th, Academician Zhong Nanshan also stated at a press conference on epidemic prevention and control held in Guangzhou that generally, the infection pattern of viruses is the same. As long as IgG antibodies appear in the body and the quantity increases significantly, the patient will not be infected again. It is not the case that if virus remnants are found, the patient is considered to be reinfected.
Zhong Nanshan analyzed that there are various factors for "re-positive" patients. Nucleic acid testing has only recently been developed, and the reagents themselves and the testing methods can have an impact. The sampling method of the nasopharynx has a significant impact on the results. As for the remnants in the intestines and feces, whether they can be transmitted to others still requires further observation.
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