Epidemiology and clinical course of COVID-19 in Shanghai, China.

Shen, YORCID logo; Zheng, F; Sun, D; Ling, Y; Chen, JORCID logo; Li, F; Li, T; Qian, Z; Zhang, Y; Xu, Q; +14 more...Liu, L; Huang, Q; Shan, F; Xu, L; Wu, J; Zhu, Z; Song, Z; Li, S; Shi, Y; Zhang, J; Wu, XORCID logo; Mendelsohn, JBORCID logo; Zhu, T; Lu, HORCID logo and (2020) Epidemiology and clinical course of COVID-19 in Shanghai, China. EMERGING MICROBES & INFECTIONS, 9 (1). pp. 1537-1545. DOI: 10.1080/22221751.2020.1787103
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Background: Novel coronavirus pneumonia (COVID-19) is prevalent around the world. We aimed to describe epidemiological features and clinical course in Shanghai. Methods: We retrospectively analysed 325 cases admitted at Shanghai Public Health Clinical Center, between January 20 and February 29, 2020. Results: 47.4% (154/325) had visited Wuhan within 2 weeks of illness onset. 57.2% occurred in 67 clusters; 40% were situated within 53 family clusters. 83.7% developed fever during the disease course. Median times from onset to first medical care, hospitalization and negative detection of nucleic acid by nasopharyngeal swab were 1, 4 and 8 days. Patients with mild disease using glucocorticoid tended to have longer viral shedding in blood and feces. At admission, 69.8% presented with lymphopenia and 38.8% had elevated D-dimers. Pneumonia was identified in 97.5% (314/322) of cases by chest CT scan. Severe-critical patients were 8% with a median time from onset to critical disease of 10.5 days. Half required oxygen therapy and 7.1% high-flow nasal oxygen. The case fatality rate was 0.92% with median time from onset to death of 16 days. Conclusion: COVID-19 cases in Shanghai were imported. Rapid identification, and effective control measures helped to contain the outbreak and prevent community transmission.


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