Symptomatic features and prognosis of 932 hospitalized patients with coronavirus disease 2019 in Wuhan

Sun, Liang Liang; Wang, Jian; Wang, Yu Sheng; Hu, Ping Fang; Zhao, Zheng Qing; Chen, Wei; Ning, Bei Fang; Yin, Chuan; Hao, Yu Shi; Wang, Qiong; Wang, Chen; Liu, Ya Long; Chen, Cheng; Yin, Ji Zhong; Huang, Hai; Xie, Wei Fen

OBJECTIVE: To discern the symptomatic features of coronavirus disease 2019 (COVID‐19) and to evaluate the severity and prognosis of the disease. METHODS: In this retrospective cohort study, 932 hospitalized patients with COVID‐19 in Wuhan were enrolled, including 52 severe and 880 non‐severe cases. All patients were followed up for 3 months after discharge. The symptomatic features and follow‐up data of the patients in both groups were analyzed and compared. RESULTS: Of the 932 patients, fever (60.0%), cough (50.8%) and fatigue (36.4%) were the most common symptoms. In total, 32.7% of the severe cases presented with gastrointestinal symptoms at disease onset, including anorexia, nausea, vomiting or diarrhea, which was significantly higher than that of the non‐severe group (P = 0.0015). The incidence of olfactory disturbance and dysgeusia was only 3.1% and 6.2%, respectively. After adjusting for age and sex, multivariate regression analysis showed that fever lasting for over 5 days (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.00‐3.62, P = 0.0498), anorexia at onset (OR 2.61, 95% CI 1.26‐5.40, P = 0.0096), and modified Medical Research Council level above grade 2 when dyspnea occurred (OR 14.19, 95% CI 7.01‐28.71, P < 0.0001) were symptomatic risk factors for severe COVID‐19. During the follow‐up, cough (6.2%), dyspnea (7.2%), fatigue (1.8%), olfactory disturbance and dysgeusia (1.5%) were the significant remaining symptoms. CONCLUSIONS: COVID‐19 causes clusters of symptoms with multiple systems involved. Certain symptomatic characteristics have predictive value for severe COVID‐19. Short‐term follow‐up data reveal that most patients have a good prognosis.