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Epidemiological and Clinical Features of Imported and Local Patients with Coronavirus Disease 2019 (COVID-19) in Hainan, China

31 Pages Posted: 24 Mar 2020

See all articles by Biao Wu

Biao Wu

Hainan Medical University - Department of Infectious Diseases

Zi-Ying Lei

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases

Kun-Liang Wu

Hainan Medical University - Department of Infectious Diseases

Jian-Rong He

University of Oxford - Green Templeton College

Hui-Juan Cao

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases

Juan Fu

Hainan Medical University - Department of Infectious Diseases

Feng Chen

Hainan Medical University - Radiology Department

Yuan Chen

Hainan Medical University - Office of Diseases Control and Prevention

Bao Chen

Hainan Medical University - Office of Diseases Control and Prevention

Xiao-Li Zhou

Hainan Medical University - Office of Diseases Control and Prevention

Tao Huang

Hainan Medical University - Clinical Laboratory

Tao Wu

Hainan Medical University - Department of Infectious Diseases

Yong-Guo Du

Hainan Medical University - Department of Infectious Diseases

Suo-Xian Chen

Hainan Medical University - Department of Infectious Diseases

Fu-Rong Xiao

Hainan Medical University - Department of Infectious Diseases

Zhi-Liang Gao

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases

Jing He

Hainan Medical University - Department of Infectious Diseases

Feng Lin

Hainan Medical University - Department of Infectious Diseases

Bing-Liang Lin

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases

More...

Abstract

Background: Hainan Island, a popular tourist destination, had received many imported cases of Coronavirus disease 2019 (COVID-19), but successfully contained the epidemics in one month. We described epidemiological and clinical characteristics of COVID-19 cases in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas.

Methods: We included 91 patients (56 imported and 35 local cases) from two designed hospitals for COVID-19 in Haikou, capital of Hainan province, from January 20 to February 19, 2020. Data on demographic, epidemiological, clinical and laboratory characteristics were extracted from medical records.

Findings: Of the 91 patients, 78 (85·7%) patients were diagnosed within the first three weeks after the first case identified (Day 1: Jan 22, 2020), while the number of local cases started to increase from the third week. No new cases occurred after Day 29. Fever (79·1%) and cough (79·1%) were two main clinical manifestations. 15 (16·5%) were severe, 14 (15·4%) had complicated infections, nine (9·9%) were admitted to ICU, and three died. All patients had abnormalities in the chest CT scan, with ground-glass opacity as the main presentation. Median duration of viral shedding in feces was longer than that in nasopharyngeal swabs (19 days vs 16 days, P=0·007). Compared with local cases, imported cases were older, have higher incidence of fever and concurrent infections, higher CRP levels, lower lymphocyte and platelet counts and levels of albumin. There was no difference in outcomes between the two groups.

Interpretation: Imported cases were more severe than local cases, but could have similar prognosis. The short epidemic period in Hainan suggests that the epidemics could be quickly brought under control if proper timely measures were taken.

Funding Statement: This study was funded by the National Science and Technology Major Project (Bing-Liang Lin, 2018ZX10302204, Bing-Liang Lin, 2017ZX10203201003), Emergency special program for 2019-nCoV of Guangdong province science and technology project (GDSTP-ESP) (Zhi-Liang Gao, 2020B111105001).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was approved by the Ethics Committee of Hainan General Hospital and The Second Affiliated Hospital of Hainan Medical University (HN-2020-31), and oral consents were obtained from all patients.

Keywords: coronavirus disease 2019 (COVID-19); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); Epidemiology; clinical chracteristics; imported case

Suggested Citation

Wu, Biao and Lei, Zi-Ying and Wu, Kun-Liang and He, Jian-Rong and Cao, Hui-Juan and Fu, Juan and Chen, Feng and Chen, Yuan and Chen, Bao and Zhou, Xiao-Li and Huang, Tao and Wu, Tao and Du, Yong-Guo and Chen, Suo-Xian and Xiao, Fu-Rong and Gao, Zhi-Liang and He, Jing and Lin, Feng and Lin, Bing-Liang, Epidemiological and Clinical Features of Imported and Local Patients with Coronavirus Disease 2019 (COVID-19) in Hainan, China (3/13/2020). Available at SSRN: https://ssrn.com/abstract=3555222 or http://dx.doi.org/10.2139/ssrn.3555222

Biao Wu

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Zi-Ying Lei

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases

Guangdong
China

Kun-Liang Wu

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Jian-Rong He

University of Oxford - Green Templeton College ( email )

Mansfield Road
Oxford, Oxfordshire OX1 4AU
United Kingdom

Hui-Juan Cao

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases

Guangdong
China

Juan Fu

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Feng Chen

Hainan Medical University - Radiology Department

Haikou
China

Yuan Chen

Hainan Medical University - Office of Diseases Control and Prevention

Haikou
China

Bao Chen

Hainan Medical University - Office of Diseases Control and Prevention

Haikou
China

Xiao-Li Zhou

Hainan Medical University - Office of Diseases Control and Prevention

Haikou
China

Tao Huang

Hainan Medical University - Clinical Laboratory

China

Tao Wu

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Yong-Guo Du

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Suo-Xian Chen

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Fu-Rong Xiao

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Zhi-Liang Gao

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases ( email )

Guangdong
China

Jing He

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Feng Lin

Hainan Medical University - Department of Infectious Diseases

Haikou
China

Bing-Liang Lin (Contact Author)

Sun Yat-Sen University (SYSU) - Department of Infectious Diseases ( email )

Guangdong
China

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