Clinical characteristics of COVID-19 in China

1. Clinical data from early cases in China describe rapid transmission and variable degrees of illness.

2. Patients commonly presented with fever and cough following a median incubation period of 4 days, though many patients presented without fever and had normal radiologic findings.

Evidence Rating: 3 (Average)

Clinical data from early cases of COVID-19 are a valuable source of information to characterize the clinical course of infected individuals and can be used to guide current clinical decision making as the pandemic continues to develop. The present study analyzed medical records for hospitalized patients between December 11, 2019 to January 31, 2020 to identify common characteristics of infected and treated patients. A total of 1099 patients treated across 552 hospitals in 30 provinces in China with laboratory-confirmed SARS-CoV-2 infection were included in the study.  Similar to previous literature, demographic data conveyed higher rates of infection in males (58.1%) versus females, and a tendency for older patients to be affected as the median age was 47 years. The median incubation period was 4 days for affected patients. The most common symptom at presentation was cough (67.8%) with fever being less common (43.8%), though majority of patients developed a fever during their hospital stay (88.7%). Fatigue (38.1%), sputum production (33.7%), shortness of breath (18.7%), sore throat (13.9%), chills (11.5%), headache (13.6%), and myalgia or arthralgia (14.9%) were commonly reported but only present in a minority of patients. Other symptoms such as gastrointestinal symptoms were relatively uncommon (<5%). On admission, patients designated as having severe disease tended to be older than those diagnosed with nonsevere disease by a median of 7 years. Majority of patients had underwent chest CT, with ground-glass opacity (56.4%) and bilateral patchy shadowing (51.8%) being the most common radiographic patterns. However, many patients with nonsevere disease presented with no abnormality on CT (17.9%). Of the patients identified, 5% were admitted to ICU, 2.3% required invasive mechanical ventilation, and 1.4% died. Median hospitalization duration was 12 days.

Click to read the study in NEJM

Image: PD

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