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

Global Health Research and Policy

Fang Shi¹  Jinhong Cao¹  Haoyu Wen¹  Fang Wang¹  Jianjun Bai¹  Sumaira Mubarik¹  Xiaoxue Liu¹  Chuanhua Yu²  Qiumian Hong³  Rui Liu⁴  Yong Yu⁵ 

[1] Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 430071, Wuhan, China;Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 430071, Wuhan, China;Global Health Institute, Wuhan University, 430072, Wuhan, China;Department of Global Health, School of Health Sciences, Wuhan University, 430071, Wuhan, China;NHC Key lab of Radiation Biology, Jilin University, 130021, Changchun, China;School of Public Health and Management, Hubei University of Medicine, 442000, Shiyan, China;

关键词: COVID-19;    Wuhan city;    Epidemiology;    Clinical diagnosis;    Risk factor;    Effective reproduction number;   

DOI  :  10.1186/s41256-021-00200-8

来源: Springer

【 摘 要 】

BackgroundTo 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.MethodsDemographics, 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.ResultsThe 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.ConclusionsThe 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.

【 授权许可】

CC BY