Epidemiological, clinical, and virological characteristics of 465 hospitalized cases of coronavirus disease 2019 (COVID-19) from Zhejiang province in China.
Adolescent
Adult
Aged
Aged, 80 and over
Betacoronavirus
/ classification
COVID-19
Child
Child, Preschool
China
/ epidemiology
Coronavirus Infections
/ diagnosis
Female
Humans
Male
Middle Aged
Mutation
Pandemics
Phylogeny
Pneumonia, Viral
/ diagnosis
Retrospective Studies
Risk Factors
SARS-CoV-2
Young Adult
Zhejiang province
coronavirus disease 2019 (COVID-19)
risk factors
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Journal
Influenza and other respiratory viruses
ISSN: 1750-2659
Titre abrégé: Influenza Other Respir Viruses
Pays: England
ID NLM: 101304007
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
25
02
2020
revised:
30
04
2020
accepted:
04
05
2020
pubmed:
13
5
2020
medline:
28
8
2020
entrez:
13
5
2020
Statut:
ppublish
Résumé
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated coronavirus disease (COVID-19) have spread throughout China. Previous studies predominantly focused on its place of origin, Wuhan, causing over estimation of the disease severity due to selection bias. We analyzed 465 confirmed cases in Zhejiang province to determine the epidemiological, clinical, and virological characteristics of COVID-19. Epidemiological, demographic, clinical, laboratory, and management data from qRT-PCR confirmed COVID-19 patients from January 17, 2020, to January 31, 2020, were collected, followed by multivariate logistic regression analysis for independent predictors of severe/critical-type COVID-19 and bioinformatic analysis for features of SARS-CoV-2 from Zhejiang province. Among 465 COVID-19 patients, median age was 45 years, while hypertension, diabetes, and chronic liver disease were the most common comorbidities. History of exposure to the epidemic area was present in 170 (36.56%) and 185 (39.78%) patients were clustered in 77 families. Severe/critical-type of COVID-19 developed in 49 (10.54%) patients. Fever and cough were the most common symptoms, while diarrhea/vomiting was reported in 58 (12.47%) patients. Multivariate analysis revealed eight risk factors for severe/critical COVID-19. Glucocorticoids and antibiotics were administered to 60 (12.90%) and 218(46.88%) patients, respectively. Bioinformatics showed four single amino acid mutations and one amino acid position loss in SARS-CoV-2 from Zhejiang province, with more similarity to humans than to viruses. SARS-CoV-2 showed virological mutations and more human transmission in Zhejiang province, indicating considerable epidemiological and clinical changes. Caution in glucocorticoid and antibiotics use is advisable.
Sections du résumé
BACKGROUND
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated coronavirus disease (COVID-19) have spread throughout China. Previous studies predominantly focused on its place of origin, Wuhan, causing over estimation of the disease severity due to selection bias. We analyzed 465 confirmed cases in Zhejiang province to determine the epidemiological, clinical, and virological characteristics of COVID-19.
METHODS
Epidemiological, demographic, clinical, laboratory, and management data from qRT-PCR confirmed COVID-19 patients from January 17, 2020, to January 31, 2020, were collected, followed by multivariate logistic regression analysis for independent predictors of severe/critical-type COVID-19 and bioinformatic analysis for features of SARS-CoV-2 from Zhejiang province.
RESULTS
Among 465 COVID-19 patients, median age was 45 years, while hypertension, diabetes, and chronic liver disease were the most common comorbidities. History of exposure to the epidemic area was present in 170 (36.56%) and 185 (39.78%) patients were clustered in 77 families. Severe/critical-type of COVID-19 developed in 49 (10.54%) patients. Fever and cough were the most common symptoms, while diarrhea/vomiting was reported in 58 (12.47%) patients. Multivariate analysis revealed eight risk factors for severe/critical COVID-19. Glucocorticoids and antibiotics were administered to 60 (12.90%) and 218(46.88%) patients, respectively. Bioinformatics showed four single amino acid mutations and one amino acid position loss in SARS-CoV-2 from Zhejiang province, with more similarity to humans than to viruses.
CONCLUSIONS
SARS-CoV-2 showed virological mutations and more human transmission in Zhejiang province, indicating considerable epidemiological and clinical changes. Caution in glucocorticoid and antibiotics use is advisable.
Identifiants
pubmed: 32397011
doi: 10.1111/irv.12758
pmc: PMC7273099
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
564-574Subventions
Organisme : National Nature Science Foundation of China
ID : 81700549
Pays : International
Organisme : National Major Science and Technology Research Projects for the Control and Prevention of Major Infectious Diseases in China
ID : 2017ZX10202202
Pays : International
Informations de copyright
© 2020 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.
Références
Lancet. 2020 Feb 15;395(10223):514-523
pubmed: 31986261
Lancet. 2020 Feb 22;395(10224):565-574
pubmed: 32007145
N Engl J Med. 2020 Mar 26;382(13):1199-1207
pubmed: 31995857
Antiviral Res. 2016 Sep;133:165-77
pubmed: 27468951
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
N Engl J Med. 2003 May 15;348(20):1967-76
pubmed: 12690091
Influenza Other Respir Viruses. 2020 Sep;14(5):564-574
pubmed: 32397011
N Engl J Med. 2020 Mar 5;382(10):929-936
pubmed: 32004427
Lancet Infect Dis. 2013 Sep;13(9):752-61
pubmed: 23891402
Semin Immunopathol. 2017 Jul;39(5):529-539
pubmed: 28466096
Trends Microbiol. 2015 Aug;23(8):468-78
pubmed: 26206723
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Sci China Life Sci. 2020 Mar;63(3):457-460
pubmed: 32009228
Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143
J Med Virol. 2020 Apr;92(4):401-402
pubmed: 31950516
N Engl J Med. 2012 Nov 8;367(19):1814-20
pubmed: 23075143
Annu Rev Virol. 2016 Sep 29;3(1):237-261
pubmed: 27578435
J Physiol Pharmacol. 2019 Apr;70(2):
pubmed: 31356181