Analysis clinical features of COVID-19 infection in secondary epidemic area and report potential biomarkers in evaluation

Weiping Ji; Gautam Bishnu; Zhenzhai Cai; Xian Shen

According to the reports of scholars in the main epidemic area, the primary clinical symptoms of COVID-19-infected patients are fever, dry cough, fatigue, and the gradual development of respiratory problems, with fever being the most typical. Only few patients will present with obvious upper respiratory symptoms (e.g., runny nose, sneezing and sore throat), and diarrhea, headache and hemoptysis are rare [5] . Patients with mild infection may show only slight fatigue and no fever [6] . Critically ill patients may develop symptoms such as acute respiratory distress syndrome, septic shock, metabolic acidosis, and coagulation dysfunction [7] in addition to symptoms such as shortness of breath, audible wet sounds in both lungs, and weak breath sounds. Dullness on percussion and tactile tremor may be increased or decreased [8] . In our study, we found that the clinical symptoms in COVID-19-infected patients in the secondary epidemic area were similar to those in patients in the primary epidemic area, but there were some inconsistencies. In the secondary epidemic area, the main symptoms were fever, mainly moderate-to low-grade fever. Cough was not usually dry and was often accompanied by white phlegm. Fatigue and muscle aches were not seen in most patients. The symptoms of upper respiratory tract infection (such as sneezing, runny nose, sore throat and itching) were not uncommon. The symptoms of chest distress and chest pain were less common in the secondary epidemic area than in the main epidemic area; this may be related to the rapid diagnosis in the secondary epidemic area and early treatment and intervention. Moreover, critical patients were rare, which may be related to the younger age of patients and the presence fewer complications in the secondary epidemic area than in the main epidemic area.