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Epidemiological Characteristics and the Clinical Severity of 1438 Patients of COVID-19 in Jingzhou, Hubei, China

28 Pages Posted: 1 Jun 2020

See all articles by Shiyi Cao

Shiyi Cao

Huazhong University of Science and Technology - School of Public Health

Qingqing Jiang

Jingzhou Center for Disease Control and Prevention

Kaifa Song

Huazhong University of Science and Technology - School of Public Health

Jigui Huang

Huazhong University of Science and Technology - School of Public Health

Dandan Li

Jingzhou Center for Disease Control and Prevention

Zuxun Lu

Jingzhou Center for Disease Control and Prevention

More...

Abstract

Background: The Corona Virus Disease 2019 (COVID-19) caused by a novel coronavirus (2019-nCoV) that threatens human society and has spread widely around the world. We aimed to describe the epidemiological characteristics and clinical severity of cases with COVID-19 in Jingzhou, China, and identify the influencing factors of clinical severity.

Methods: In this retrospective study, we included all laboratory-confirmed COVID-19 cases in Jingzhou from Dec 21, 2019 to Mar 10, 2020. All cases were analyzed for demographics, epidemiology, and the clinical severity of COVID-19. We utilized descriptive statistics, Chi-squared (χ2) test, Wilcoxon rank sum test and Binary logistic regression model for statistical analyses.

Findings: Of the 1438 cases with COVID-19, the mortality was 3.3%. 751 (52.2%) were male, the median age was 49 years (interquartile range, 36-60; rang 3 months to 95 years). For the classification of clinical severity, 5.1% of the cases were asymptomatic, 70.5% were mild or general, and 24.4 % were severe or critical cases. The duration from onset to admission was mostly within 7 days, and 72.7% of the patients were treated at Grade Ⅱ-class A hospitals. 64.8% of the patients were within two days from onset to receiving a treatment. Clinical severity was significantly associated with the gender, age, the grade of the hospital, the duration from onset to admission, patients with chronic non-communicable diseases and the exposure to farmers' markets. Elderly people (³65 years) had a greater risk of being clinically severe (odds ratio [OR]: 16.464, 95% confidence interval [CI]: 2.177-124.539, P=0.007) compared with the patients under the age of 18 years. The duration from onset to admission more than 14 days had increased the risk of being worse by 3.2 times ( P <0.001) compared with the duration were 0-2 days. Patients with chronic non-communicable diseases were more clinically severe (OR: 1.659, 95% CI: 1.270-2.167, P <0.001 ). Patients with exposure to a clustered outbreak site or a contact history of the confirmed or asymptomatic cases were the protective factors for severe clinical condition ( P <0.05). The risk of disease becoming severe was higher in patients who had been to farmers' markets (OR: 1.438, 95% CI: 1.101-1.997, P =0.009).

Interpretation: About one quarter of COVID--19 cases in Jingzhou were clinically severe. People who were older, patients who went to the hospital late, cases who had chronic non-communicable diseases and those exposed to the farmer's market, were more likely to have more severe clinical features. These findings may inform other countries and regions to identify or predict high-risk groups of clinically severe cases.

Funding Statement: This study was funded by the National Natural Science Foundation of China (NSFC, 71603091).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: The study was approved by Jingzhou Center for Disease Control and Prevention (CDC) Ethics Committee, Hubei province, China and the Research Ethics Committee in Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Waiver of informed consent for collection of epidemiological data from patients with COVID-19 was granted by the National Health Commission of China as part of the infectious disease outbreak investigation. All identifiable personal information was removed for privacy protection.

Keywords: COVID-19; 2019-nCoV; epidemiology; clinical severity; Jingzhou

Suggested Citation

Cao, Shiyi and Jiang, Qingqing and Song, Kaifa and Huang, Jigui and Li, Dandan and Lu, Zuxun, Epidemiological Characteristics and the Clinical Severity of 1438 Patients of COVID-19 in Jingzhou, Hubei, China (4/18/2020). Available at SSRN: https://ssrn.com/abstract=3582808 or http://dx.doi.org/10.2139/ssrn.3582808

Shiyi Cao (Contact Author)

Huazhong University of Science and Technology - School of Public Health ( email )

1037 Luoyu Rd
Wuhan
China

Qingqing Jiang

Jingzhou Center for Disease Control and Prevention

Jingzhou 434000, Hubei
China

Kaifa Song

Huazhong University of Science and Technology - School of Public Health

1037 Luoyu Rd
Wuhan
China

Jigui Huang

Huazhong University of Science and Technology - School of Public Health

1037 Luoyu Rd
Wuhan
China

Dandan Li

Jingzhou Center for Disease Control and Prevention

Jingzhou 434000, Hubei
China

Zuxun Lu

Jingzhou Center for Disease Control and Prevention

Jingzhou 434000, Hubei
China