Disease burden and clinical severity of the first pandemic wave of COVID-19 in Wuhan, China

  1. Juan Yang
  2. Xinhua Chen
  3. Xiaowei Deng
  4. Zhiyuan Chen
  5. Hui Gong
  6. Han Yan
  7. Qianhui Wu
  8. Huilin Shi
  9. Shengjie Lai
  10. Marco Ajelli
  11. Cecile Viboud
  12. Prof Hongjie Yu

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Abstract

The novel coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, where the initial wave of intense community transmissions was cut short by interventions. Using multiple data sources, here we estimate the disease burden and clinical severity by age of COVID-19 in Wuhan from December 1, 2019 to March 31, 2020. Our estimates account for the sensitivity of the laboratory assays, prospective community screenings, and healthcare seeking behaviors. Rates of symptomatic cases, medical consultations, hospitalizations and deaths were estimated at 796 (95% CI: 703–977), 489 (472–509), 370 (358–384), and 36.2 (35.0–37.3) per 100,000 persons, respectively. The COVID-19 outbreak in Wuhan had a higher burden than the 2009 influenza pandemic or seasonal influenza in terms of hospitalization and mortality rates, and clinical severity was similar to that of the 1918 influenza pandemic. Our comparison puts the COVID-19 pandemic into context and could be helpful to guide intervention strategies and preparedness for the potential resurgence of COVID-19.

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  1. Version published to 10.1038/s41467-020-19238-2
  2. ScreenIT

    SciScore for 10.1101/2020.08.27.20183228: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has some limitations. Firstly, health seeking behavior maybe not constant throughout the epidemic. In this survey, study participants in Wuhan were asked to review their history of ARI between December 2019 and March 2020, and whether they sought medical assistance for these symptoms13. However, since we did not obtain the onset date of these symptoms, and hence we could not stratify health-seeking behavior by COVID-19 epidemic phase. Instead, we calculated the overall proportion of ARIs cases who sought medical care during the epidemic. If the distribution of onset dates of ARIs cases in our sample was skewed towards the early phase (late January) of the epidemic, the proportion seeking medical care may be underestimated due to the overwhelmed health system. That would lead to an overestimation of the number of symptomatic COVID-19 cases. Conversely, if the distribution of onset dates was skewed towards the late phases of epidemic, we may have underestimated the number of symptomatic COVID-19 cases. We conducted a sensitivity analysis on the probability of seeking medical care, using the lower and upper limits of the 95%CI of our survey. This analysis resulted in minor changes in the disease burden and clinical severity estimates compared to the baseline analysis. Secondly, missing or incorrect records of COVID-19 cases are inevitable during an outbreak, particularly in the period when the healthcare capacity is overwhelmed. A verification of reported COVID-19 case...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    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 10.1101/2020.08.27.20183228v1 on medRxiv