During the initial phase of the Covid-19 outbreak, the diagnosis of the disease was complicated by the diversity in symptoms and imaging findings and in the severity of disease at the time of presentation.
The 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.
Clinical Characteristics of Coronavirus Disease in China
Characteristic | |
Age * Median (yr) * Distribution – 0-14 yr – 15-49 yr – 50-64 yr – ≥65 yr |
– 47 (35-58) – 0.9 55.1 28.9 15.1 |
Female sex (%) | 41.9 |
Smoking history (%) * Never smoked * Former smoker * Current smoker |
– 85.4 1.9 12.6 |
Median incubation period (days) | 4 (2-7) |
Fever on admission * Patients (%) * Median temperature * Distribution of temperature (%) – <37.5 °C – 37.5-38.0 °C – 38.1-39.0 °C – >39.0 °C |
– 43.8 37.3 (36.7-38.0) – 9.9 30.9 46.9 12.3 |
Fever during hospitalization * Patients (%) * Median highest temperature (°C) – <37.5 °C – 37.5-38.0 °C – 38.1-39.0 °C – >39.0 °C |
– 88.7 38.3 (37.8-38.9) 9.9 30.9 46.9 12.3 |
Symptoms (%) * Conjunctival congestion * Nasal congestion * Headache * Cough * Sore throat * Sputum production * Fatigue * Hemoptysis * Shortness of breath * Nausea or vomiting * Diarrhea * Myalgia or arthralgia * Chills |
– 0.3 4.8 13.6 67.8 13.9 33.7 38.1 0.9 18.7 5.0 3.8 14.9 11.5 |
Signs of infection (%) * Throat congestion * Tonsil swelling * Enlargement of lymph nodes * Rash |
– 1.7 2.1 0.2 0.2 |
Coexisting disorder (%) * Any * Chronic obstructive pulmonary disease * Diabetes * Hypertension * Coronary heart disease * Cerebrovascular disease * Hepatitis B infection * Cancer * Chronic renal disease * Immunodeficiency |
– 23.7 1.1 7.4 15.0 2.3 1.4 2.1 0.9 0.7 0.2 |
Radiologic findings | |
Abnormalities on chest radiograph (%) * Ground-glass opacity * Local patchy shadowing * Bilateral patchy shadowing * Interstitial abnormalities |
59.1 20.1 28.1 36.5 4.4 |
Abnormalities on chest CT (%) * Ground-glass opacity * Local patchy shadowing * Bilateral patchy shadowing * Interstitial abnormalities |
86.2 56.4 41.9 51.8 14.7 |
Laboratory findings | |
Median Pao2:Fio2 ratio | 3.9 (2.9-4.7) |
White-cell count * Median (per mm3) |
– 4700 (3500-6000) |
Distribution (%) * >10,000 per mm3 * <4000 per mm3 |
– 5.9 33.7 |
Lymphocyte count * Median (per mm3) * Distribution (%) – <1500 per mm3 |
– 1000 /(700-1300) – 83.2 |
Distribution of other findings (%) * C-reactive protein ≥10 mg/liter * Procalcitonin ≥0.5 ng/ml * Lactate dehydrogenase ≥250 U/liter * Aspartate aminotransferase >40 U/liter * Alanine aminotransferase >40 U/liter * Total bilirubin >17.1 μmol/liter * Creatine kinase ≥200 U/liter * Creatinine ≥133 μmol/liter * D-dimer ≥0.5 mg/liter |
– 60.7 5.5 41.0 22.2 21.3 10.5 13.7 1.6 46.4 |
Complications | |
Septic shock (%) Acute respiratory distress syndrome (%) Acute kidney injury (%) Disseminated intravascular coagulation (%) Rhabdomyolysis (%) Physician-diagnosed pneumonia (%) Median time until development of pneumonia (days) * After initial Covid-19 diagnosis * After onset of Covid-19 symptoms |
1.1 3.4 0.5 0.1 0.2 91.1 – 0 (0-1) 3 (1-6) |
Clinical outcomes at data cutoff (%) * Discharge from hospital * Death * Recovery * Hospitalization |
– 5.0 1.4 0.8 93.6 |
References:
- Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;10.1056/NEJMoa2002032. [Medline]
- Xu XW, Wu XX, Jiang XG, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020;368:m606. Published 2020 Feb 19. [Medline]
- Yang W, Cao Q, Qin L, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020;S0163-4453(20)30099-2. [Medline]
Created Mar 06, 2020.