The Comparison of Epidemiological Characteristics Between Confirmed and Clinically Diagnosed Cases With COVID-19 in Wuhan, China
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.
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Posted 21 Dec, 2020
On 14 Feb, 2021
On 21 Dec, 2020
Received 21 Dec, 2020
On 20 Dec, 2020
Received 20 Dec, 2020
Invitations sent on 19 Dec, 2020
On 16 Dec, 2020
On 16 Dec, 2020
On 16 Dec, 2020
On 16 Dec, 2020
The Comparison of Epidemiological Characteristics Between Confirmed and Clinically Diagnosed Cases With COVID-19 in Wuhan, China
Posted 21 Dec, 2020
On 14 Feb, 2021
On 21 Dec, 2020
Received 21 Dec, 2020
On 20 Dec, 2020
Received 20 Dec, 2020
Invitations sent on 19 Dec, 2020
On 16 Dec, 2020
On 16 Dec, 2020
On 16 Dec, 2020
On 16 Dec, 2020
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