Epidemiological and Clinical Features of Imported and Local Patients with Coronavirus Disease 2019 (COVID-19) in Hainan, China
31 Pages Posted: 24 Mar 2020More...
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
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