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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 Feb 19; 368:m606.BMJ

Abstract

OBJECTIVE

To study the clinical characteristics of patients in Zhejiang province, China, infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) responsible for coronavirus disease 2019 (covid-2019).

DESIGN

Retrospective case series.

SETTING

Seven hospitals in Zhejiang province, China.

PARTICIPANTS

62 patients admitted to hospital with laboratory confirmed SARS-Cov-2 infection. Data were collected from 10 January 2020 to 26 January 2020.

MAIN OUTCOME MEASURES

Clinical data, collected using a standardised case report form, such as temperature, history of exposure, incubation period. If information was not clear, the working group in Hangzhou contacted the doctor responsible for treating the patient for clarification.

RESULTS

Of the 62 patients studied (median age 41 years), only one was admitted to an intensive care unit, and no patients died during the study. According to research, none of the infected patients in Zhejiang province were ever exposed to the Huanan seafood market, the original source of the virus; all studied cases were infected by human to human transmission. The most common symptoms at onset of illness were fever in 48 (77%) patients, cough in 50 (81%), expectoration in 35 (56%), headache in 21 (34%), myalgia or fatigue in 32 (52%), diarrhoea in 3 (8%), and haemoptysis in 2 (3%). Only two patients (3%) developed shortness of breath on admission. The median time from exposure to onset of illness was 4 days (interquartile range 3-5 days), and from onset of symptoms to first hospital admission was 2 (1-4) days.

CONCLUSION

As of early February 2020, compared with patients initially infected with SARS-Cov-2 in Wuhan, the symptoms of patients in Zhejiang province are relatively mild.

Authors+Show Affiliations

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.Department of Infectious Disease, Wenzhou Central Hospital, Wenzhou, Zhejiang Province, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.Department of Infectious Disease, Taizhou Enze Medical Centre (Group), Enze Hospital, Taizhou, Zhejiang Province, China.Department of Infectious Disease, First People's Hospital of Wenling, Wenling, Zhejiang Province, China.Department of Infectious Disease, Affiliated Zhoushan Hospital, Wenzhou Medical University, Zhoushan, Zhejiang Province, China ljli@zju.edu.cn.Department of Respiratory and Critical Care Medicine, Yinzhou People's Hospital, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, Ningbo City, Zhejiang Province, China.Department of Infectious Disease, Taizhou Hospital, Taizhou, Zhejiang Province, China.Department of Infectious Disease, ShuLan (Hangzhou) Hospital affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang Province, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China ljli@zju.edu.cn.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32075786

Citation

Xu, Xiao-Wei, 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 (Clinical Research Ed.), vol. 368, 2020, pp. m606.
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.
Xu, X. W., Wu, X. X., Jiang, X. G., Xu, K. J., Ying, L. J., Ma, C. L., Li, S. B., Wang, H. Y., Zhang, S., Gao, H. N., Sheng, J. F., Cai, H. L., Qiu, Y. Q., & Li, L. J. (2020). Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ (Clinical Research Ed.), 368, m606. https://doi.org/10.1136/bmj.m606
Xu XW, 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 Feb 19;368:m606. PubMed PMID: 32075786.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. AU - Xu,Xiao-Wei, AU - Wu,Xiao-Xin, AU - Jiang,Xian-Gao, AU - Xu,Kai-Jin, AU - Ying,Ling-Jun, AU - Ma,Chun-Lian, AU - Li,Shi-Bo, AU - Wang,Hua-Ying, AU - Zhang,Sheng, AU - Gao,Hai-Nv, AU - Sheng,Ji-Fang, AU - Cai,Hong-Liu, AU - Qiu,Yun-Qing, AU - Li,Lan-Juan, Y1 - 2020/02/19/ PY - 2020/2/21/entrez PY - 2020/2/23/pubmed PY - 2020/2/29/medline SP - m606 EP - m606 JF - BMJ (Clinical research ed.) JO - BMJ VL - 368 N2 - OBJECTIVE: To study the clinical characteristics of patients in Zhejiang province, China, infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) responsible for coronavirus disease 2019 (covid-2019). DESIGN: Retrospective case series. SETTING: Seven hospitals in Zhejiang province, China. PARTICIPANTS: 62 patients admitted to hospital with laboratory confirmed SARS-Cov-2 infection. Data were collected from 10 January 2020 to 26 January 2020. MAIN OUTCOME MEASURES: Clinical data, collected using a standardised case report form, such as temperature, history of exposure, incubation period. If information was not clear, the working group in Hangzhou contacted the doctor responsible for treating the patient for clarification. RESULTS: Of the 62 patients studied (median age 41 years), only one was admitted to an intensive care unit, and no patients died during the study. According to research, none of the infected patients in Zhejiang province were ever exposed to the Huanan seafood market, the original source of the virus; all studied cases were infected by human to human transmission. The most common symptoms at onset of illness were fever in 48 (77%) patients, cough in 50 (81%), expectoration in 35 (56%), headache in 21 (34%), myalgia or fatigue in 32 (52%), diarrhoea in 3 (8%), and haemoptysis in 2 (3%). Only two patients (3%) developed shortness of breath on admission. The median time from exposure to onset of illness was 4 days (interquartile range 3-5 days), and from onset of symptoms to first hospital admission was 2 (1-4) days. CONCLUSION: As of early February 2020, compared with patients initially infected with SARS-Cov-2 in Wuhan, the symptoms of patients in Zhejiang province are relatively mild. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/32075786/Clinical_findings_in_a_group_of_patients_infected_with_the_2019_novel_coronavirus__SARS_Cov_2__outside_of_Wuhan_China:_retrospective_case_series_ L2 - http://www.bmj.com/lookup/pmidlookup?view=long&pmid=32075786 DB - PRIME DP - Unbound Medicine ER -