Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series

Abstract

Background: Recent studies have focused on initial clinical and epidemiological characteristics of the coronavirus disease 2019 (COVID-19), which is the mainly revealing situation in Wuhan, Hubei.

Aim: This study aims to reveal more data on the epidemiological and clinical characteristics of COVID-19 patients outside of Wuhan, Zhejiang, China.

Design: This study was a retrospective case series.

Methods: Eighty-eight cases of laboratory-confirmed and three cases of clinically confirmed COVID-19 were admitted to five hospitals in Zhejiang province, China. Data were collected from 20 January 2020 to 11 February 2020.

Results and discussion: Of all 91 patients, 88 (96.70%) were laboratory-confirmed COVID-19 with throat swab samples that tested positive for SARS-Cov-2, three (3.30%) cases were clinically diagnosed. The median age of the patients was 50 (36.5-57) years, and female accounted for 59.34%. In this sample, 40 (43.96%) patients had contracted the disease from local cases, 31 (34.07%) patients had been to Wuhan/Hubei, eight (8.79%) patients had contacted with people from Wuhan, and 11 (12.09%) patients were diagnosed after having flown together in the same flight with no passenger that could later be identified as the source of infection. In particular within the city of Ningbo, 60.52% cases can be traced back to an event held in a temple. The most common symptoms were fever (71.43%), cough (60.44%) and fatigue (43.96%). The median of incubation period was 6 (interquartile range 3-8) days and the median time from the first visit to a doctor to the confirmed diagnosis was 1 (1-2) days. According to the chest computed tomography scans, 67.03% cases had bilateral pneumonia.

Conclusions: Social activity cluster, family cluster and flying alongside with persons already infected with COVID-19 were how people got infected with COVID-19 in Zhejiang.

Figure 1.

Transverse chest CT from a 39-year-old man, showing ground-glass opacities of bilateral lungs near the pleura (a and b) on Day 1 from symptom onset, and increased bilateral ground-glass opacities and consolidation (c and d) on Day 5 from symptom onset, and slightly absorbed ground-glass opacities (e and f) on Day 7 from symptom onset after 7-day treatment.

Figure 2.

(a) Normal chest CT scan from a 37-year-old man. (b) Chest CT scan from a 57-year-old woman, showing scattered opacities in middle right lobe. (c) Chest CT scan from a 39-year-old man, showing bilateral ground-glass opacities. (d) Chest CT scan from a 64-year-old woman, showing typical left pleural ground-glass opacities.