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J Glob Health ; 10(1): 011004, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-186549


Background: Since the emergence of coronavirus disease 2019 (COVID-19) in Hubei province of China by the end of 2019, it has burned its way across the globe, resulting in a still fast-growing death toll that far exceeded those from severe acute respiratory syndrome (SARS) in less than two months. As there is a paucity of evidence on which population is more likely to progress into severe conditions among cases, we looked into the first cluster of death cases, aiming to add to current evidence and reduce panic among the population. Methods: We prospectively collected the demographic and clinical data of the first 38 fatalities whose information was made public by the Health Commission of Hubei province and the official Weibo account of China Central Television news center, starting from 9 January through 24 January 2020. The death cases were described from four aspects (gender and age characteristics, underlying diseases, the time course of death, symptoms at the incipience of illness and hospital admission). Results: Among the 38 fatalities, 71.05% were male, and 28.95% were female, with the median age of 70 years (interquartile range (IQR) = 65-81). Persons aged 66-75 made up the largest share. Twenty-five cases had a history of chronic diseases. The median time between the first symptoms and death was 12.50 days (IQR = 10.00-16.25), while the median time between the admission and death was 8.50 (IQR = 5.00-12.00) days. In persons aged over 56 years, the time between the first symptoms and death decreased with age, and so did the time between the admission and death, though the latter increased again in persons aged over 85 years. The major first symptoms included fever (52.63%), cough (31.58%), dyspnea (23.68%), myalgia and fatigue (15.79%). Conclusions: Among the death cases, persons with underlying diseases and aged over 65 made up the majority. The time between the first symptoms and death decreased with the advanced age. In all the age groups, males dominated the fatalities.

Coronavirus Infections/mortality , Coronavirus , Pandemics , Pneumonia, Viral/mortality , Age Distribution , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/diagnosis , Cough/epidemiology , Disease Outbreaks , Dyspnea/epidemiology , Female , Fever/epidemiology , Humans , Male , Middle Aged , Pneumonia, Viral/diagnosis , Prospective Studies , SARS-CoV-2 , Sex Distribution
J Med Virol ; 92(7): 833-840, 2020 07.
Article in English | MEDLINE | ID: covidwho-164692


In December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, and has spread globally. However, the transmission route of SARS-CoV-2 has not been fully understood. In this study, we aimed to investigate SARS-CoV-2 shedding in the excreta of COVID-19 patients. Electronical medical records, including demographics, clinical characteristics, laboratory and radiological findings of enrolled patients were extracted and analyzed. Pharyngeal swab, stool, and urine specimens were collected and tested for SARS-CoV-2 RNA by real-time reverse transcription polymerase chain reaction. Viral shedding at multiple time points in specimens was recorded, and its correlation analyzed with clinical manifestations and the severity of illness. A total of 42 laboratory-confirmed patients were enrolled, 8 (19.05%) of whom had gastrointestinal symptoms. A total of 28 (66.67%) patients tested positive for SARS-CoV-2 RNA in stool specimens, and this was not associated with the presence of gastrointestinal symptoms and the severity of illness. Among them, 18 (64.29%) patients remained positive for viral RNA in the feces after the pharyngeal swabs turned negative. The duration of viral shedding from the feces after negative conversion in pharyngeal swabs was 7 (6-10) days, regardless of COVID-19 severity. The demographics, clinical characteristics, laboratory and radiologic findings did not differ between patients who tested positive and negative for SARS-CoV-2 RNA in the feces. Viral RNA was not detectable in urine specimens from 10 patients. Our results demonstrated the presence of SARS-CoV-2 RNA in the feces of COVID-19 patients and suggested the possibility of SARS-CoV-2 transmission via the fecal-oral route.

Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Disease Outbreaks , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , RNA, Viral/isolation & purification , Virus Shedding , Adult , COVID-19 , China/epidemiology , Coronavirus Infections/diagnosis , Electronic Health Records , Feces/virology , Female , Humans , Male , Middle Aged , Pandemics , Pharynx/virology , Pneumonia, Viral/diagnosis , RNA, Viral/genetics , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index