Transmission and clinical characteristics of coronavirus disease 2019 in 104 outside‐Wuhan patients, China

  1. Chengfeng Qiu
  2. Ziwei Deng
  3. Qian Xiao
  4. Yuanlu Shu
  5. Ye Deng
  6. Hongqiang Wang
  7. Xin Liao
  8. Huiwen Liu
  9. Dinghui Zhou
  10. Xiang Zhao
  11. Jianliang Zhou
  12. Jin Wang
  13. Zhihua Shi
  14. Da Long

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Abstract

Cases of coronavirus disease 2019 (COVID‐19) emigrating from Wuhan escalated the risk of spreading the disease in other cities. This report focused on outside‐Wuhan patients to assess the transmission and clinical characteristics of this illness. Contact investigation was conducted on each patient who was admitted to the assigned hospitals in Hunan Province (geographically adjacent to Wuhan) from 22 January to 23 February 2020. Cases were confirmed by the polymerase chain reaction test. Demographic, clinical, and outcomes were collected and analyzed. Of the 104 patients, 48 (46.15%) were cases who immigrated from Wuhan; 93 (89.42%) had a definite contact history with infection. Family clusters were the major body of patients. Transmission along the chain of three “generations” was observed. Five asymptomatic infected cases were found and two of them infected their relatives. Mean age was 43 (range, 8‐84) years, and 49 (47.12%) were male. The median incubation period was 6 (range, 1‐32) days, which of 8 patients ranged from 18 to 32 days, 96 (92.31%) were discharged, and 1 (0.96%) died. The average hospital stay was 10 (range, 8‐14) days. Family but not community transmission became the main body of infections in the two centers, suggesting the timely control measures after the Wuhan shutdown worked well. Asymptomatic transmission demonstrated here warned us that it may lead to the widespread of COVID‐19. A 14‐day quarantine may need to be prolonged.

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  1. Version published to 10.1002/jmv.25975
  2. ScreenIT

    SciScore for 10.1101/2020.03.04.20026005: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethics approval: This study was approved by the ethics committee of the First People’s Hospital of Huaihua (KY-2020013102) and the Central Hospital of Shaoyang (KY-202000103), China.
    Consent: Considering the infectious of NCP, we conducted an oral informed consent with every patient instead of written informed consent (www.chictr.org.cn Chi CTR2000029734).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical tests were performed using SPSS version 25.0.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    While the controversy of sharply increased cases and medical shortage in the early and outbreak stage in Wuhan, patients in Wuhan may have limitation to fully reflect the true epidemiological characteristics of this illness. Evidence has suggested person-to-person transmission of COVID-19 via droplets or skin touch2,3,11. The data of this study showed a notable feature is clustering occurrence, most patients were infected from their family members, relatives or friends through a close contact. Only 11 (10.53%) of this study patients were sporadic cases that hardly identified infector source, suggesting that community transmission of COVID-19 is not developed rapidly in the two cities (Huaihua and Shaoyang); this also matches the smooth growth of total confirmed cases. Of note, strict control measures by the local government produced a powerful effect on the slowing spread. We are eager to know how infectious the virus is. Except the confirmed cases, whether the asymptomatic COVID-19-carriers has the infectious is unclear. Three cases (C37, C44 and C49) infected from the same person (C’3) who ever traveled to Wuhan. But until now, C’3 did not develop any symptoms. Though we did not take a PCR test to confirm whether C’3 was a virus-carrier, the same contact history and the similar onset time of her three relatives indicate that C’3 was an asymptomatic COVID-19-carrier. Five asymptomatic patients were found in this study, one patients (C’4) who infected three family members (C9...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.03.04.20026005 on medRxiv