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

Emerg Microbes Infect. 2020 Dec;9(1):1537-1545. doi: 10.1080/22221751.2020.1787103.

Abstract

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.

Keywords: COVID-19; clinical characteristics; clinical course; epidemiology; viral shedding.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19
  • China / epidemiology
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / therapy
  • Female
  • Follow-Up Studies
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / therapy
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Virus Shedding
  • Young Adult

Grants and funding

This work was supported by Shanghai Science and Technology Committee under Grant 20431900403, 20431900400, 20411950200 and 17411969600; Shanghai Municipal Health Commission under Grant 2020NCP001: Special Emergency Project for the Prevention and Treatment of COVID-19 with Traditional Chinese Medicine in Shanghai and shslczdzk01102: Shanghai Municipal Key Clinical Specialty; Ministry of Science and Technology of the People's Republic of China under Grant 2017ZX10202101: National Key Project of ‘13th five-year' Infectious Diseases Program; Fudan University under Grant RC-QT-2019-01.