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Background: To put COVID-19 patients into hospital timely, the clinical diagnosis had been implemented in Wuhan in the early outbreak. Here we compared the epidemiological characteristics of laboratory-confirmed and clinically diagnosed cases with COVID-19 in Wuhan.
Methods: Demographics, case severity and outcomes of 29886 confirmed cases and 21960 clinically diagnosed cases reported between December 2019 and February 24, 2020, were compared. The risk factors were estimated, and the effective reproduction number of SARS-CoV-2 (Rt) was also calculated.
Results: The interval between symptom onset and diagnosis of confirmed and clinically diagnosed cases reduced gradually as time went by, and the proportion of severe and critical cases as well as case fatality rates of the two groups all decreased over time. The proportion of severe and critical cases (21.5% vs 14.0%, P<0.0001) and case fatality rates (5.2% vs 1.2%, P<0.0001) of confirmed cases were all higher than those of clinically diagnosed cases. Risk factors for death we observed in all two groups were older age, male, severe or critical cases. Rt showed a downward trend after the lockdown of Wuhan, it dropped below 1.0 on February 6 among confirmed cases, and February 8 among clinically diagnosed cases.
Conclusion: Public health responses taken in Wuhan, including clinical diagnosis, have contributed to slow transmission. In cases where testing kits are insufficient, clinical diagnosis is effective, which is helpful to quarantine or treat infected cases as soon as possible, and prevent the epidemic from worsening. To decrease the case fatality rate of COVID-19, it is necessary to strengthen early warning and intervention of severe and critical elderly men.
Keywords
COVID-19, Wuhan city, Epidemiology, Clinically diagnosis, Risk factor, Effective reproduction number
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CURRENT STATUS: Under Review
Version 1
Posted 21 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 14 Feb, 2021
Reviewer #2 agreed
On 21 Dec, 2020
Review #2 received
Received 21 Dec, 2020
Reviewer #1 agreed
On 20 Dec, 2020
Review #1 received
Received 20 Dec, 2020
Reviewers invited
Invitations sent on 19 Dec, 2020
First submitted
On 16 Dec, 2020
Editor assigned
On 16 Dec, 2020
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On 16 Dec, 2020
Editor invited
On 16 Dec, 2020
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This preprint is under consideration at Global Health Research and Policy. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 21 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 14 Feb, 2021
Reviewer #2 agreed
On 21 Dec, 2020
Review #2 received
Received 21 Dec, 2020
Reviewer #1 agreed
On 20 Dec, 2020
Review #1 received
Received 20 Dec, 2020
Reviewers invited
Invitations sent on 19 Dec, 2020
First submitted
On 16 Dec, 2020
Editor assigned
On 16 Dec, 2020
Submission checks complete
On 16 Dec, 2020
Editor invited
On 16 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: To put COVID-19 patients into hospital timely, the clinical diagnosis had been implemented in Wuhan in the early outbreak. Here we compared the epidemiological characteristics of laboratory-confirmed and clinically diagnosed cases with COVID-19 in Wuhan.
Methods: Demographics, case severity and outcomes of 29886 confirmed cases and 21960 clinically diagnosed cases reported between December 2019 and February 24, 2020, were compared. The risk factors were estimated, and the effective reproduction number of SARS-CoV-2 (Rt) was also calculated.
Results: The interval between symptom onset and diagnosis of confirmed and clinically diagnosed cases reduced gradually as time went by, and the proportion of severe and critical cases as well as case fatality rates of the two groups all decreased over time. The proportion of severe and critical cases (21.5% vs 14.0%, P<0.0001) and case fatality rates (5.2% vs 1.2%, P<0.0001) of confirmed cases were all higher than those of clinically diagnosed cases. Risk factors for death we observed in all two groups were older age, male, severe or critical cases. Rt showed a downward trend after the lockdown of Wuhan, it dropped below 1.0 on February 6 among confirmed cases, and February 8 among clinically diagnosed cases.
Conclusion: Public health responses taken in Wuhan, including clinical diagnosis, have contributed to slow transmission. In cases where testing kits are insufficient, clinical diagnosis is effective, which is helpful to quarantine or treat infected cases as soon as possible, and prevent the epidemic from worsening. To decrease the case fatality rate of COVID-19, it is necessary to strengthen early warning and intervention of severe and critical elderly men.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
This is a list of supplementary files associated with this preprint. Click to download.
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