Clinical Characteristics of Coronavirus Disease 2019 in China

Wei-Jie Guan, Zheng-Yi Ni, Yu Hu, Wen-Hua Liang, Chun-Quan Ou, Jian-Xing He, Lei Liu, Hong Shan, Chun-Liang Lei, David S C Hui, Bin Du, Lan-Juan Li, Guang Zeng, Kwok-Yung Yuen, Ru-Chong Chen, Chun-Li Tang, Tao Wang, Ping-Yan Chen, Jie Xiang, Shi-Yue Li, Jin-Lin Wang, Zi-Jing Liang, Yi-Xiang Peng, Li Wei, Yong Liu, Ya-Hua Hu, Peng Peng, Jian-Ming Wang, Ji-Yang Liu, Zhong Chen, Gang Li, Zhi-Jian Zheng, Shao-Qin Qiu, Jie Luo, Chang-Jiang Ye, Shao-Yong Zhu, Nan-Shan Zhong, China Medical Treatment Expert Group for Covid-19, Nan-Shan Zhong, Lan-Juan Li, Guang Zeng, George Fu Gao, Kwok-Yung Yuen, Wei-Jie Guan, Zheng-Yi Ni, Yu Hu, Wen-Hua Liang, Chun-Quan Ou, Jian-Xing He, Lei Liu, Hong Shan, Chun-Liang Lei, David S C Hui, Bin Du, Lan-Juan Li, Guang Zeng, Kwok-Yung Yuen, Ru-Chong Chen, Chun-Li Tang, Tao Wang, Ping-Yan Chen, Jie Xiang, Shi-Yue Li, Jin-Lin Wang, Zi-Jing Liang, Yi-Xiang Peng, Li Wei, Yong Liu, Ya-Hua Hu, Peng Peng, Jian-Ming Wang, Ji-Yang Liu, Zhong Chen, Gang Li, Zhi-Jian Zheng, Shao-Qin Qiu, Jie Luo, Chang-Jiang Ye, Shao-Yong Zhu, Nan-Shan Zhong, China Medical Treatment Expert Group for Covid-19, Nan-Shan Zhong, Lan-Juan Li, Guang Zeng, George Fu Gao, Kwok-Yung Yuen

Abstract

Background: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients.

Methods: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death.

Results: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission.

Conclusions: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.).

Copyright © 2020 Massachusetts Medical Society.

Figures

Figure 1. Distribution of Patients with Covid-19…
Figure 1. Distribution of Patients with Covid-19 across Mainland China.
Shown are the official statistics of all documented, laboratory-confirmed cases of coronavirus disease 2019 (Covid-19) throughout China, according to the National Health Commission as of February 4, 2020. The numerator denotes the number of patients who were included in the study cohort and the denominator denotes the number of laboratory-confirmed cases for each province, autonomous region, or provincial municipality, as reported by the National Health Commission.

References

    1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
    1. Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020;395:565-574.
    1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-733.
    1. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020;395:514-523.
    1. Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med. DOI: 10.1056/NEJMc2001272.
    1. Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. DOI: 10.1056/NEJMc2001468.
    1. Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet 2020. January 31 (Epub ahead of print).
    1. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. DOI: 10.1056/NEJMoa2001316.
    1. World Health Organization. Coronavirus disease (COVID-19) outbreak ().
    1. Holshue ML, DeBolt C, Lindquist S, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med. DOI: 10.1056/NEJMoa2001191.
    1. National Health Commission of the People’s Republic of China home page ().
    1. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-513.
    1. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020. February 7 (Epub ahead of print).
    1. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance. January 28, 2020. ().
    1. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Disease Society of America. Am J Respir Crit Care Med 2019;200(7):e45-e67.
    1. Gao H-N, Lu H-Z, Cao B, et al. Clinical findings in 111 cases of influenza A (H7N9) virus infection. N Engl J Med 2013;368:2277-2285.
    1. World Health Organization. Coronavirus disease (COVID-19) technical guidance: laboratory testing for 2019-nCoV in humans ().
    1. Lei H, Li Y, Xiao S, et al. Routes of transmission of influenza A H1N1, SARS CoV, and norovirus in air cabin: comparative analyses. Indoor Air 2018;28:394-403.
    1. Otter JA, Donskey C, Yezli S, Douthwaite S, Goldenberg SD, Weber DJ. Transmission of SARS and MERS coronaviruses and influenza virus in healthcare settings: the possible role of dry surface contamination. J Hosp Infect 2016;92:235-250.
    1. Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet 2015;386:995-1007.
    1. Minodier L, Charrel RN, Ceccaldi PE, et al. Prevalence of gastrointestinal symptoms in patients with influenza, clinical significance, and pathophysiology of human influenza viruses in faecal samples: what do we know? Virol J 2015;12:215-215.
    1. Leung WK, To KF, Chan PK, et al. Enteric involvement of severe acute respiratory syndrome-associated coronavirus infection. Gastroenterology 2003;125:1011-1017.
    1. Assiri A, McGeer A, Perl TM, et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med 2013;369:407-416.
    1. World Health Organization. Coronavirus disease (COVID-2019) situation reports ().

Source: PubMed

3
Prenumerera