Clinical Characteristics of Coronavirus Disease 2019 in China - PubMed (original) (raw)
. 2020 Apr 30;382(18):1708-1720.
doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.
Zheng-Yi Ni 1, Yu Hu 1, Wen-Hua Liang 1, Chun-Quan Ou 1, Jian-Xing He 1, Lei Liu 1, Hong Shan 1, Chun-Liang Lei 1, David S C Hui 1, Bin Du 1, Lan-Juan Li 1, Guang Zeng 1, Kwok-Yung Yuen 1, Ru-Chong Chen 1, Chun-Li Tang 1, Tao Wang 1, Ping-Yan Chen 1, Jie Xiang 1, Shi-Yue Li 1, Jin-Lin Wang 1, Zi-Jing Liang 1, Yi-Xiang Peng 1, Li Wei 1, Yong Liu 1, Ya-Hua Hu 1, Peng Peng 1, Jian-Ming Wang 1, Ji-Yang Liu 1, Zhong Chen 1, Gang Li 1, Zhi-Jian Zheng 1, Shao-Qin Qiu 1, Jie Luo 1, Chang-Jiang Ye 1, Shao-Yong Zhu 1, Nan-Shan Zhong 1; China Medical Treatment Expert Group for Covid-19
Collaborators, Affiliations
- PMID: 32109013
- PMCID: PMC7092819
- DOI: 10.1056/NEJMoa2002032
Clinical Characteristics of Coronavirus Disease 2019 in China
Wei-Jie Guan et al. N Engl J Med. 2020.
Abstract
Background: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients.
Methods: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death.
Results: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission.
Conclusions: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.).
Copyright © 2020 Massachusetts Medical Society.
Figures
Figure 1. Distribution of Patients with Covid-19 across Mainland China.
Shown are the official statistics of all documented, laboratory-confirmed cases of coronavirus disease 2019 (Covid-19) throughout China, according to the National Health Commission as of February 4, 2020. The numerator denotes the number of patients who were included in the study cohort and the denominator denotes the number of laboratory-confirmed cases for each province, autonomous region, or provincial municipality, as reported by the National Health Commission.
Comment in
- Clinical Characteristics of Covid-19 in China.
Zavascki AP, Falci DR. Zavascki AP, et al. N Engl J Med. 2020 May 7;382(19):1859. doi: 10.1056/NEJMc2005203. Epub 2020 Mar 27. N Engl J Med. 2020. PMID: 32220202 No abstract available. - Clinical Characteristics of Covid-19 in China.
Chen ATC, Coura-Filho GB, Rehder MHH. Chen ATC, et al. N Engl J Med. 2020 May 7;382(19):1860. doi: 10.1056/NEJMc2005203. Epub 2020 Mar 27. N Engl J Med. 2020. PMID: 32220203 No abstract available. - Clinical Characteristics of Covid-19 in China.
Rolf JD. Rolf JD. N Engl J Med. 2020 May 7;382(19):1860. doi: 10.1056/NEJMc2005203. Epub 2020 Mar 27. N Engl J Med. 2020. PMID: 32220204 No abstract available. - Clinical Characteristics of Covid-19 in China.
Henry BM, Vikse J. Henry BM, et al. N Engl J Med. 2020 May 7;382(19):1860-1861. doi: 10.1056/NEJMc2005203. Epub 2020 Mar 27. N Engl J Med. 2020. PMID: 32220205 No abstract available. - Importing coronavirus disease 2019 (COVID-19) into China after international air travel.
Zhang XA, Fan H, Qi RZ, Zheng W, Zheng K, Gong JH, Fang LQ, Liu W. Zhang XA, et al. Travel Med Infect Dis. 2020 May-Jun;35:101620. doi: 10.1016/j.tmaid.2020.101620. Epub 2020 Mar 25. Travel Med Infect Dis. 2020. PMID: 32222421 Free PMC article. No abstract available. - COVID-19, diabetes mellitus and ACE2: The conundrum.
Pal R, Bhansali A. Pal R, et al. Diabetes Res Clin Pract. 2020 Apr;162:108132. doi: 10.1016/j.diabres.2020.108132. Epub 2020 Mar 29. Diabetes Res Clin Pract. 2020. PMID: 32234504 Free PMC article. No abstract available. - Commentary: What is the relationship between Covid-19 and cardiovascular disease?
Ferrari R, Di Pasquale G, Rapezzi C. Ferrari R, et al. Int J Cardiol. 2020 Jul 1;310:167-168. doi: 10.1016/j.ijcard.2020.03.074. Epub 2020 Mar 31. Int J Cardiol. 2020. PMID: 32276773 Free PMC article. No abstract available. - Impact of COVID-19: perspectives from gastroenterology.
Tay SW, Teh KKJ, Wang LM, Ang TL. Tay SW, et al. Singapore Med J. 2020 Sep;61(9):460-462. doi: 10.11622/smedj.2020051. Epub 2020 Apr 13. Singapore Med J. 2020. PMID: 32279480 Free PMC article. No abstract available. - How we deal with the COVID-19 epidemic in an Italian paediatric onco-haematology clinic located in a region with a high density of cases.
Sainati L, Biffi A. Sainati L, et al. Br J Haematol. 2020 May;189(4):640-642. doi: 10.1111/bjh.16699. Epub 2020 Apr 30. Br J Haematol. 2020. PMID: 32298461 Free PMC article. No abstract available. - COVID-19: the risk of respiratory techniques in healthcare workers.
Torres-Castro R, Vilaró J, Vera-Uribe R. Torres-Castro R, et al. Spinal Cord. 2020 Jun;58(6):724-725. doi: 10.1038/s41393-020-0472-0. Epub 2020 Apr 21. Spinal Cord. 2020. PMID: 32317765 Free PMC article. No abstract available. - Rising Concern on Damaged Testis of COVID-19 Patients.
Chen F, Lou D. Chen F, et al. Urology. 2020 Aug;142:42. doi: 10.1016/j.urology.2020.04.069. Epub 2020 Apr 25. Urology. 2020. PMID: 32343996 Free PMC article. No abstract available. - Continuous positive airway pressure to avoid intubation in SARS-CoV-2 pneumonia: a two-period retrospective case-control study.
Oranger M, Gonzalez-Bermejo J, Dacosta-Noble P, Llontop C, Guerder A, Trosini-Desert V, Faure M, Raux M, Decavele M, Demoule A, Morélot-Panzini C, Similowski T. Oranger M, et al. Eur Respir J. 2020 Aug 13;56(2):2001692. doi: 10.1183/13993003.01692-2020. Print 2020 Aug. Eur Respir J. 2020. PMID: 32430410 Free PMC article. - A predictive model for disease progression in non-severely ill patients with coronavirus disease 2019.
Ji M, Yuan L, Shen W, Lv J, Li Y, Chen J, Zhu C, Liu B, Liang Z, Lin Q, Xie W, Li M, Chen Z, Lu X, Ding Y, An P, Zhu S, Gao M, Ni H, Hu L, Shi G, Shi L, Dong W. Ji M, et al. Eur Respir J. 2020 Jul 16;56(1):2001234. doi: 10.1183/13993003.01234-2020. Print 2020 Jul. Eur Respir J. 2020. PMID: 32430433 Free PMC article. - Smoking amidst the COVID-19 Pandemic - the invisible threat?
Anand S. Anand S. Med J Malaysia. 2020 May;75(3):309-310. Med J Malaysia. 2020. PMID: 32467553 - Cholesterol: A new game player accelerating vasculopathy caused by SARS-CoV-2?
Cao X, Yin R, Albrecht H, Fan D, Tan W. Cao X, et al. Am J Physiol Endocrinol Metab. 2020 Jul 1;319(1):E197-E202. doi: 10.1152/ajpendo.00255.2020. Epub 2020 Jun 5. Am J Physiol Endocrinol Metab. 2020. PMID: 32501731 Free PMC article. - [Medical rehabilitation and COVID-19: Current impact and future challenges in rehabilitation services].
Expósito Tirado JA, Rodríguez-Piñero Durán M, Echevarría Ruiz de Vargas C. Expósito Tirado JA, et al. Rehabilitacion (Madr). 2020 Oct-Dec;54(4):228-230. doi: 10.1016/j.rh.2020.06.002. Epub 2020 Jul 8. Rehabilitacion (Madr). 2020. PMID: 32723577 Free PMC article. Spanish. No abstract available. - Maintaining Patient Safety and Data Integrity of Nonalcoholic Steatohepatitis Clinical Trials During the Severe Acute Respiratory Syndrome-Coronavirus 2 Pandemic.
Alkhouri N, Kohli A, Loomba R, Harrison SA. Alkhouri N, et al. Hepatology. 2020 Nov;72(5):1509-1513. doi: 10.1002/hep.31522. Epub 2020 Oct 29. Hepatology. 2020. PMID: 32794597 Free PMC article. No abstract available. - Collateral damage of the COVID-19 pandemic: Exacerbation of antimicrobial resistance and disruptions to antimicrobial stewardship programmes?
Chibabhai V, Duse AG, Perovic O, Richards GA. Chibabhai V, et al. S Afr Med J. 2020 Jun 2;110(7):572-573. doi: 10.7196/SAMJ.2020.v110i7.14917. S Afr Med J. 2020. PMID: 32880323 No abstract available. - Identification and validation of predictive factors for progression to severe COVID-19 pneumonia by proteomics.
Di B, Jia H, Luo OJ, Lin F, Li K, Zhang Y, Wang H, Liang H, Fan J, Yang Z. Di B, et al. Signal Transduct Target Ther. 2020 Oct 3;5(1):217. doi: 10.1038/s41392-020-00333-1. Signal Transduct Target Ther. 2020. PMID: 33011738 Free PMC article. No abstract available. - Thank You for Not Smoking.
Hashmi SK, Hussain F, Hays JT. Hashmi SK, et al. Mayo Clin Proc. 2020 Oct;95(10):2062-2064. doi: 10.1016/j.mayocp.2020.08.012. Mayo Clin Proc. 2020. PMID: 33012336 Free PMC article. No abstract available. - Tobacco and COVID-19: A position from Sociedade Portuguesa de Pneumologia.
Matos CP, Boléo-Tomé JP, Rosa P, Morais A. Matos CP, et al. Pulmonology. 2021 Mar-Apr;27(2):91-93. doi: 10.1016/j.pulmoe.2020.11.002. Epub 2020 Nov 17. Pulmonology. 2021. PMID: 33303350 Free PMC article. No abstract available. - COVID-19 Pandemic and the Burden of Acute Kidney Injury: The Known and the Unknown.
Imam TH. Imam TH. Perm J. 2020 Dec;25:1. doi: 10.7812/TPP/20.140. Perm J. 2020. PMID: 33635771 Free PMC article.
Similar articles
- Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Wang D, et al. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. JAMA. 2020. PMID: 32031570 Free PMC article. - Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2.
Xu X, Yu C, Qu J, Zhang L, Jiang S, Huang D, Chen B, Zhang Z, Guan W, Ling Z, Jiang R, Hu T, Ding Y, Lin L, Gan Q, Luo L, Tang X, Liu J. Xu X, et al. Eur J Nucl Med Mol Imaging. 2020 May;47(5):1275-1280. doi: 10.1007/s00259-020-04735-9. Epub 2020 Feb 28. Eur J Nucl Med Mol Imaging. 2020. PMID: 32107577 Free PMC article. - Epidemiological and clinical characteristics analysis of COVID-19 in the surrounding areas of Wuhan, Hubei Province in 2020.
Zheng Y, Xiong C, Liu Y, Qian X, Tang Y, Liu L, Leung EL, Wang M. Zheng Y, et al. Pharmacol Res. 2020 Jul;157:104821. doi: 10.1016/j.phrs.2020.104821. Epub 2020 Apr 30. Pharmacol Res. 2020. PMID: 32360481 Free PMC article. - Maternal and infant outcomes of full-term pregnancy combined with COVID-2019 in Wuhan, China: retrospective case series.
Chen Y, Bai J. Chen Y, et al. Arch Gynecol Obstet. 2020 Sep;302(3):545-551. doi: 10.1007/s00404-020-05573-8. Epub 2020 Jul 21. Arch Gynecol Obstet. 2020. PMID: 32696241 Free PMC article. Review. - Clinical Characteristics and Morbidity Associated With Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit.
Suleyman G, Fadel RA, Malette KM, Hammond C, Abdulla H, Entz A, Demertzis Z, Hanna Z, Failla A, Dagher C, Chaudhry Z, Vahia A, Abreu Lanfranco O, Ramesh M, Zervos MJ, Alangaden G, Miller J, Brar I. Suleyman G, et al. JAMA Netw Open. 2020 Jun 1;3(6):e2012270. doi: 10.1001/jamanetworkopen.2020.12270. JAMA Netw Open. 2020. PMID: 32543702 Free PMC article. Review.
Cited by
- Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study.
Chen SY, Ng CJ, Huang YB, Lo HY. Chen SY, et al. BMC Infect Dis. 2024 Nov 18;24(1):1315. doi: 10.1186/s12879-024-10223-4. BMC Infect Dis. 2024. PMID: 39558236 - Analysis of the potentially pathogenic bacteria of lower respiratory tract infections in children per-, during and post-COVID-19: a retrospective study.
Xu X, Meng L, Li J, Zhang Y, Liu B, Jiang W, Hao C. Xu X, et al. Eur J Clin Microbiol Infect Dis. 2024 Nov 18. doi: 10.1007/s10096-024-04991-9. Online ahead of print. Eur J Clin Microbiol Infect Dis. 2024. PMID: 39556174 - Embracing impermanence: life events, fear of COVID-19 and psychological distress in the context of the postepidemic era: a moderated mediation model.
Fu S, Ren Z, Yang Z, Li Z, Wang J, Zhao T, Huang X. Fu S, et al. BMC Psychol. 2024 Nov 15;12(1):665. doi: 10.1186/s40359-024-02165-y. BMC Psychol. 2024. PMID: 39548596 Free PMC article. - [Morbidity and mortality in hospitalised patients vaccinated versus hospitalised patients not vaccinated against COVID-19 in three regions of Cameroon].
Bevela JY, Billong S, Njankouo YM, Kenko I, Bonsou G. Bevela JY, et al. Pan Afr Med J. 2024 Jul 18;48:114. doi: 10.11604/pamj.2024.48.114.40348. eCollection 2024. Pan Afr Med J. 2024. PMID: 39545032 Free PMC article. French. - Assessment of COVID-19 severity levels and associated factors among patients admitted to the treatment centers in Southern Ethiopia.
Tirore LL, Sergindo MT, Areba AS, Hailegebireal AH, Desalegn M. Tirore LL, et al. Front Med (Lausanne). 2024 Oct 31;11:1403615. doi: 10.3389/fmed.2024.1403615. eCollection 2024. Front Med (Lausanne). 2024. PMID: 39544381 Free PMC article.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources