The comparison of epidemiological characteristics between confirmed and clinically diagnosed cases with COVID-19 during the early epidemic in Wuhan,China

Background:To put COVID-19 patients into hospital timely,the clinical diagnosis had been implemented in Wuhan in the early epidemic.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 29,886 confirmed cases and 21,960 clinically diagnosed cases reported between December 2019 and February 24,2020,were compared.The risk factors were estimated,and the effective reproduction number(Rt)of SARS-CoV-2 was also calculated.Results:The age and occupation distribution of confirmed cases and clinically diagnosed cases were consistent,and their sex ratio were 1.0 and 0.9,respectively.The epidemic curve of clinical diagnosis cases was similar to that of confirmed cases,and the city centers had more cumulative cases and higher incidence density than suburbs in both of two groups.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 both of two groups were older age,male,severe or critical cases.Rt showed the same trend in two groups,it dropped below 1.0 on February 6 among confirmed cases,and February 8 among clinically diagnosed cases.Conclusions:The demographic characteristics and spatiotemporal distributions of confirmed and clinically diagnosed cases are roughly similar,but the disease severity and clinical outcome of clinically diagnosed cases are better than those of confirmed cases.In cases when detection kits are insufficient during the early epidemic,the implementation of clinical diagnosis is necessary and effective.

The epidemiological characteristics of deaths with COVID-19 in the early stage of epidemic in Wuhan,China

Objectives:To analyze the epidemiological characteristics of COVID-19 related deaths in Wuhan,China and comprehend the changing trends of this epidemic along with analyzing the prevention and control measures in Wuhan.Methods:Through the China’s Infectious Disease Information System,we collected information about COVID-19 associated deaths from December 15,2019 to February 24,2020 in Wuhan.We analyzed the patient’s demographic characteristics,drew epidemiological curve and made geographic distribution maps of the death toll in each district over time,etc.ArcGIS was used to plot the numbers of daily deaths on maps.Statistical analyses were performed using SPSS and@Risk software.Results:As of February 24,2020,a total of 1833 deaths were included.Among the deaths with COVID-19,mild type accounted for the most(37.2%),followed by severe type(30.1%).The median age was 70.0(inter quartile range:63.0-79.0)years.Most of the deaths were distributed in 50-89 age group,whereas no deaths occurred in 0-9 age group.Additionally,the male to female ratio was 1.95:1.A total of 65.7%of the deaths in Wuhan combined with underlying diseases,and was more pronounced among males.Most of the underlying diseases included hypertension,diabetes and cardiovascular diseases.The peak of daily deaths appeared on February 14 and then declined.The median interval from symptom onset to diagnosis was 10.0(6.0-14.0)days;the interval from onset to diagnosis gradually shortened.The median intervals from diagnosis to death and symptom onset to deaths were 6.0(2.0-11.0),17.0(12.0-22.0)days,respectively.Most of the disease was centralized in central urban area with highest death rate in Jianghan District.Conclusion:COVID-19 poses a greater threat to the elderly people and men with more devastating effects,particularly in the presence of underlying diseases.The geographical distributions show that the epidemic in the central area of Wuhan is more serious than that in the surrounding areas.Analysis of deaths as of February 24 indicates that a tremendous improvement of COVID-19 epidemic in Wuhan has achieved by effective control measures taken by Wuhan Government.

Correction to:The epidemiological characteristics of deaths with COVID-19 in the early stage of epidemic in Wuhan,China

Correction to:Glob Health Res Policy(2020)5:54 https://doi.org/10.1186/s41256-020-00183-y After publication of this article[1],it is noticed the format of author names in reference 7 is incorrect.The correct reference 7 is below:Wang X,Yu Y,Hu Y,Yu C.COVID-19 analysis and forecast based on exponential smoothing model in Hubei Province.J Public Health Prev Med.2020;31(1):1-4.(in Chinese)The original article has been updated.