COVID-19 patient characteristics across Mainland China [Classics Series]

This study summary is an excerpt from the book 2 Minute Medicine’s The Classics in Medicine: Summaries of the Landmark Trials

1. This cohort study of patients with novel coronavirus 2019 (COVID-19) found that a primary composite endpoint of intensive care unit (ICU) admission, mechanical ventilation, or mortality occurred in 6.1% of patients.

2. The majority of patients developed fever (88.7%) and cough (67.8%) throughout their hospitalization.

Original Date of Publication: April 2020

Study Rundown: In this cohort study, admission data was analyzed from patients with COVID-19 admitted to hospitals across mainland China. Approximately half of patients were female and 15 to 49 years old. The most common symptoms of COVID-19 were fever and cough. Nausea, vomiting, and diarrhea occurred in less than a tenth of patients. Patients with severe COVID-19 were more likely to be older and have another underlying illness. Additionally, those with severe COVID-19 were at increased risk of the primary composite endpoint of ICU admission, mechanical ventilation, or mortality. The major limitation of this study is the variation in available data for patients across different hospitals. Overall, COVID-19 patients seem to predominantly present as having fever and/or cough, with ICU admission, mechanical ventilation, and mortality more likely in those with severe disease.

Click to read the study in NEJM

In-Depth [cohort study]: This cohort study compared clinical presentations and outcomes of COVID-19 patients admitted to 552 hospitals across 30 provinces, autonomous regions, and municipalities in mainland China (n = 1099). Approximately half of patients were male (58.1%) with a median age of 47 years. The primary composite endpoint occurred in a total of 6.1% of patients, with 5.0% admitted to the ICU, 1.4% mortality, and 2.3% mechanically ventilated. During their hospital admission, 88.7% of patients experienced fever as compared to 67.8% reporting a cough. Over half of patients had ground glass opacity on chest computed tomography (56.4%) and most experienced lymphocytopenia (83.2%). Treatment principally consisted of intravenous antibiotic therapy (58.0%), oxygen therapy (41.3%), and antiviral therapy (35.8%) with a mean hospitalization of 12 days.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine. 2020 Apr 30;382(18):1708-20.

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