Evaluation of the clinical characteristics of suspected or confirmed cases of COVID-19 during home care with isolation: A new retrospective analysis based on O2O

  1. Hui Xu
  2. Sufang Huang
  3. Shangkun Liu
  4. Juan Deng
  5. Bo Jiao
  6. Ling Ai
  7. Yaru Xiao
  8. Li Yan
  9. Shusheng Li

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Abstract

Background

The recent outbreak of the novel coronavirus in December 2019 (COVID-19) has activated top-level response nationwide. We developed a new treatment model based on the online-to-offline (O2O) model for the home isolated patients, because in the early stages the medical staff were insufficient to cope with so many patients.

Methods

In this single-centered, retrospective study, we enrolled 48 confirmed/suspected COVID-19 patients who underwent home isolation in Wuhan between January 6 and January 31, 2020. By WeChat and online document editing all patients were treated with medical observation scale. The clinical indications such as Fever, Muscle soreness, Dyspnea and Lack of strength were collected with this system led by medical staff in management, medicine, nursing, rehabilitation and psychology.

Findings

The mean age of 48 patients was 39·08±13·88 years, 35(72·9%) were women. Compared with non-hospitalized patients, inpatients were older(≥70years, 2·4% vs 33·3%, P<0·04). All inpatients had fever, 50% inpatients had coughs and showed infiltration in both lungs at the time of diagnosis. 33·3% inpatients exhibited negative changes in their CT results at initial diagnosis. The body temperature of non-hospitalized patients with mild symptoms returned to normal by day 4-5. While dyspnea peaked on day 6 for non-hospitalized patients with mild symptoms, it persisted in hospitalized patients and exacerbated over time. The lack of strength and muscle soreness were both back to normal by day 4 for non-hospitalized patients.

Interpretation

Monitoring the trends of symptoms is more important for identifying severe cases. Excessive laboratory data and physical examination are not necessary for the evaluation of patients with mild symptoms. The system we developed is the first to convert the subjective symptoms of patients into objective scores. This type of O2O, subjective-to-objective strategy may be used in regions with similar highly infectious diseases to minimize the possibility of infection among medical staff.

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    SciScore for 10.1101/2020.02.26.20028084: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by Tongji Hospital Ethics Committee before data were collected retrospectively.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    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:
    This study has several limitations. First, our results were generated under a specific time and environment and were limited by the suddenness and complexity of the disease during the early stage, diversity and latency of the clinical manifestations, and the depletion of medical resources at the time. As a result, some data were incomplete and may result in bias in this study. Second, this study was a small sample survey of healthcare workers and their families. Aside from irreproducible interaction and discipline, the results obtained from this small sample may contain bias that need to be interpreted with caution. In addition, the 48 patients had no complications. Although the course of disease has shown a different trend between patients with mild and severe symptoms, it still had limitation. We will discuss it in further retrospective analysis of large samples in the future. Finally, we found later from our questionnaire that wearing a mask and keeping a distance of 1 meter, especially during home quarantine, were poorly accepted and inadequately executed by most patients(results to be published in another manuscript). Therefore, how to better implement these measures will need to be further pondered in subsequent work.

    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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  2. Version published to 10.1101/2020.02.26.20028084v1 on medRxiv