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Observations about symptomatic and asymptomatic infections of 494 patients with COVID-19 in Shanghai, China.
Am J Infect Control. 2020 09; 48(9):1045-1050.AJ

Abstract

BACKGROUND

Humans are generally susceptible to SARS-CoV-2, which has caused a global pandemic of COVID-19. The screening of infected people in the population still mainly depends on clinical symptoms. However, there is limited research on the characteristics of clinical symptoms in different populations, especially in imported cases.

METHODS

To retrospectively analyze the clinical data of 494 confirmed COVID-19 patients admitted to a designated hospital in Shanghai from January 20, 2020, to March 31, 2020, we compared the clinical manifestations in different populations and their influencing factors in COVID-19 patients.

RESULTS

(1) Of the 494 patients, 453 (91.7%) had different symptoms at admission, and 39 (7.89%) patients were asymptomatic. (2) We compared the symptoms of patients according to different stratifications and found the following results: (a) The proportion of dyspnea was significantly higher in male patients than in female patients (P < .05). (b) The proportions of a stuffy nose, sore throat, and olfactory and gustatory dysfunction were significantly higher in children than in adult patients (P < .05). (c) The proportions of fever, chest tightness, shortness of breath, and fatigue were significantly higher in local cases than in imported cases. In comparison, the proportions of nasal congestion, stuffy nose, sore throat, headache, and olfactory and gustatory dysfunction were significantly lower in imported cases than in imported cases (P < .05). (d) The proportions of chest tightness, shortness of breath, and dyspnea were significantly higher in severely ill patients than in those with mild symptoms (P < .05). (3) Thirty-one asymptomatic patients were significantly younger than symptomatic patients, and they had a higher proportion of imported cases, white blood cell and lymphocyte count levels, and fewer abnormal CT cases than the group of symptomatic patients (P < .05). (4) The number of days since the onset of the disease needed for the symptoms to disappear was associated with the epidemiological history (imported cases), the number of days until the pharyngeal swab nucleic acid test turned negative, the days of hospitalization, the days of onset, and the white blood cell and lymphocyte count levels (P < .05).

CONCLUSIONS

The majority of COVID-19 patients (91.7%) had early symptoms, whereas 7.89% of COVID-19 patients were asymptomatic. Younger patients had fewer symptoms, mainly the upper respiratory symptoms, and the illness condition was milder, which was more common in imported cases. Elderly male patients had severe symptoms when admitted. The number of days needed for the patient's symptoms to disappear was closely related to the number of days necessary for the pharyngeal swab nucleic acid test to turn negative.

Authors+Show Affiliations

Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Infection Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Respiratory, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.Research Unit, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. Electronic address: zgyi@fudan.edu.cn.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. Electronic address: qianzhiping@shphc.org.cn.Research Unit, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China; Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. Electronic address: luhongzhou@fudan.edu.cn.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32645475

Citation

Mei, Xue, et al. "Observations About Symptomatic and Asymptomatic Infections of 494 Patients With COVID-19 in Shanghai, China." American Journal of Infection Control, vol. 48, no. 9, 2020, pp. 1045-1050.
Mei X, Zhang Y, Zhu H, et al. Observations about symptomatic and asymptomatic infections of 494 patients with COVID-19 in Shanghai, China. Am J Infect Control. 2020;48(9):1045-1050.
Mei, X., Zhang, Y., Zhu, H., Ling, Y., Zou, Y., Zhang, Z., Guo, H., Liu, Y., Cheng, X., Liu, M., Huang, W., Wang, J., Yi, Z., Qian, Z., & Lu, H. (2020). Observations about symptomatic and asymptomatic infections of 494 patients with COVID-19 in Shanghai, China. American Journal of Infection Control, 48(9), 1045-1050. https://doi.org/10.1016/j.ajic.2020.06.221
Mei X, et al. Observations About Symptomatic and Asymptomatic Infections of 494 Patients With COVID-19 in Shanghai, China. Am J Infect Control. 2020;48(9):1045-1050. PubMed PMID: 32645475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Observations about symptomatic and asymptomatic infections of 494 patients with COVID-19 in Shanghai, China. AU - Mei,Xue, AU - Zhang,Yuyi, AU - Zhu,Hui, AU - Ling,Yun, AU - Zou,Ying, AU - Zhang,Zhengguo, AU - Guo,Hongying, AU - Liu,Yu, AU - Cheng,Xingxia, AU - Liu,Min, AU - Huang,Wei, AU - Wang,Jiefei, AU - Yi,Zhigang, AU - Qian,Zhiping, AU - Lu,Hongzhou, Y1 - 2020/07/06/ PY - 2020/05/16/received PY - 2020/05/28/revised PY - 2020/06/29/accepted PY - 2020/7/10/pubmed PY - 2020/9/12/medline PY - 2020/7/10/entrez KW - Novel coronavirus pneumonia KW - SARS-CoV-2 KW - Symptoms SP - 1045 EP - 1050 JF - American journal of infection control JO - Am J Infect Control VL - 48 IS - 9 N2 - BACKGROUND: Humans are generally susceptible to SARS-CoV-2, which has caused a global pandemic of COVID-19. The screening of infected people in the population still mainly depends on clinical symptoms. However, there is limited research on the characteristics of clinical symptoms in different populations, especially in imported cases. METHODS: To retrospectively analyze the clinical data of 494 confirmed COVID-19 patients admitted to a designated hospital in Shanghai from January 20, 2020, to March 31, 2020, we compared the clinical manifestations in different populations and their influencing factors in COVID-19 patients. RESULTS: (1) Of the 494 patients, 453 (91.7%) had different symptoms at admission, and 39 (7.89%) patients were asymptomatic. (2) We compared the symptoms of patients according to different stratifications and found the following results: (a) The proportion of dyspnea was significantly higher in male patients than in female patients (P < .05). (b) The proportions of a stuffy nose, sore throat, and olfactory and gustatory dysfunction were significantly higher in children than in adult patients (P < .05). (c) The proportions of fever, chest tightness, shortness of breath, and fatigue were significantly higher in local cases than in imported cases. In comparison, the proportions of nasal congestion, stuffy nose, sore throat, headache, and olfactory and gustatory dysfunction were significantly lower in imported cases than in imported cases (P < .05). (d) The proportions of chest tightness, shortness of breath, and dyspnea were significantly higher in severely ill patients than in those with mild symptoms (P < .05). (3) Thirty-one asymptomatic patients were significantly younger than symptomatic patients, and they had a higher proportion of imported cases, white blood cell and lymphocyte count levels, and fewer abnormal CT cases than the group of symptomatic patients (P < .05). (4) The number of days since the onset of the disease needed for the symptoms to disappear was associated with the epidemiological history (imported cases), the number of days until the pharyngeal swab nucleic acid test turned negative, the days of hospitalization, the days of onset, and the white blood cell and lymphocyte count levels (P < .05). CONCLUSIONS: The majority of COVID-19 patients (91.7%) had early symptoms, whereas 7.89% of COVID-19 patients were asymptomatic. Younger patients had fewer symptoms, mainly the upper respiratory symptoms, and the illness condition was milder, which was more common in imported cases. Elderly male patients had severe symptoms when admitted. The number of days needed for the patient's symptoms to disappear was closely related to the number of days necessary for the pharyngeal swab nucleic acid test to turn negative. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/32645475/Observations_about_symptomatic_and_asymptomatic_infections_of_494_patients_with_COVID_19_in_Shanghai_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-6553(20)30646-5 DB - PRIME DP - Unbound Medicine ER -