Epidemiological and clinical features of 291 cases with coronavirus disease 2019 in areas adjacent to Hubei, China: a double-center observational study

Xu Chen; Fang Zheng; Yanhua Qing; Shuizi Ding; Danhui Yang; Cheng Lei; Zhilan Yin; Xianglin Zhou; Dixuan Jiang; Qi Zuo; Jun He; Jianlei Lv; Ping Chen; Yan Chen; Hong Peng; Honghui Li; Yuanlin Xie; Jiyang Liu; Zhiguo Zhou; Hong Luo

The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10.1101/2020.03.03.20030353 doi: medRxiv preprint transmission intensity of the virus, especially in the first or second generation of transmission, and may indicate that the virulence of the virus will decrease after limited generations of transmission. 10, 12 Therefore doctors in areas outside Wuhan should be more cautious in clinical decision making when the patient have a recent history of exposure in Wuhan, including Wuhan residents and those who recently traveled to Wuhan before disease onset. The proportion of family clusters infection in our study was 39.2% which was lower than other studies. 3 Besides, none of our patient was medical staff while 1080 medical staff were infected in Wuhan until February 11, 2020. 2 For demographic and clinical characteristics, 53.6% patients aged between 15-49 years, followed by the 50-64 years age group (27.5%). In severe/critical group, 32.0% and 40.0% patients aged from 50 to 64 and over 64 respectively, consistent with report of Guan et al. 13 Female and male patients both accounted for half in all three groups. The median time from disease onset to first admission in our study was 5.0 days. Similar to the recent publications, [13] [14] [15] [16] our data also showed that fever, cough and fatigue were the most common symptoms. The severe/critical group patients were more likely to have two or more symptoms at admission. While most symptoms were more frequently seen in severe/critical group, nausea or vomiting were more common in mild group, which may indicate different body responses to SARS-CoV-2 infection in patients with different health state and immune system defensive characteristics. 58.0% patients in severe/critical group had at least one underlying disease. In concert with the study of Guan et al, 13 Bases on these findings, we suggest clinicians pay more attention to and closely observe patients with multiple symptoms and underlying diseases to prevent disease deterioration.