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.
