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Epidemiological and Clinical Characteristics of COVID-19 Infection Outside Wuhan, China: A Multicenter Study
16 Pages Posted: 2 Mar 2020More...
Background: Numerous cases of COVID-19 were confirmed in the world in succession. We reported the epidemiological and clinical features of 478 confirmed cases from a multicentre study outside of Wuhan, China.
Methods: We collected patients who were transferred by Emergency Medical Service (EMS) to the designated hospitals in four major cities including Beijing, Chongqing, Jinan and Nanning in China. The information on demographic, epidemiological, clinical, diagnostic type and outcome were obtained. We compared the characteristics between imported and indigenous cases, and calculated the fatality,and the rate of severe cases, mild and asymptomatic cases to generate the pyramid of COVID-19 infection.
Findings: From Jan 20 to Feb 20, 2020, 478 patients were transferred from the general hospitals to the designated hospitals for special treatment of the COVID-19 infection by EMS in Beijing, Chongqing, Jinan and Nanning. Among them, 328 (68·6%) patients were associated with clustering. The mean age of patients was 46·9 years old and 49·8% were male. The most common symptoms at the onset of illness were fever (69·7% ), cough (47·5%), fatigue (24·5%), dyspnea (8·4%) and headache (7·9%). Till Feb 20, 41·4% patients have been discharged and 57·7% patients remained in hospital in our study. Mild and asymptomatic cases accounted for the majority (83%), the severe cases accounted for 16%, and the fatality rate was 0·8%. In the study, most cases (313, 65·5%) were indigenous, while 165 (34·5%) were imported. During the early stage, imported cases were dominant, which declined from Feb 1, from which time indigenous cases rise sharply. Compared with indigenous cases, the imported cases was significantly different concerning gender composition (P=0·002), classification of severity (P=0·006), the highest body temperature (P<0·001), family clustering history (P<0·001) and the primary outcome (P<0·001).
Interpretation: On the basis of this study, we generated the pyramid of COVID-19 infection, and found the pattern of infection had shifted from the imported to indigenous gradually, and then the daily new cases was declined quickly, this attributed to the government’s potent prevent and control, the epidemic is clearly under control in China. Preventing import from outside and controlling export on inside should being a basic principle for resisting COVID-19 infection, however, if out of control, the region or area will be chaos.
Funding Statement: This study was supported by the Beijing Municipal Science and Technology Project (Z191100004419003), the Chongqing Science and Technology Project (CSTC2020JSCX-FYZX0045) , Shandong Provincial Key Science and Technology Innovation Project (2020SFXGFY03) and the National Science and Technology Fundamental Resources Investigation Project (2018FY100600).
Declaration of Interests: All authors declare no competing interests.
Ethics Approval Statement: The study was approved by Ethics Committee of Beijing Emergency Medical Center (No.2020-01) and the written informed consent was waived.
Keywords: COVID-19; Epidemiology; clinic; characteristics; multicentre study
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