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Assessing risk factors for SARS-CoV-2 infection in patients presenting with symptoms in Shanghai, China: a multicentre, observational cohort study.
Mao, Bei; Liu, Yang; Chai, Yan-Hua; Jin, Xiao-Yan; Lu, Hai-Wen; Yang, Jia-Wei; Gao, Xi-Wen; Song, Xiao-Lian; Bao, Hong; Wang, An; Gu, Wen-Chao; Zhao, Lei; Pan, Jie-Ping; Li, Fan; Zhang, Tie-Feng; Qian, Ye-Chang; Du, Chun-Ling; Ding, Wei; Tu, Chun-Lin; Chu, De-Jie; Li, Chun; Ye, Ling; Luo, Yong; Zheng, Cui-Xia; Yu, Rong-Huan; Qiu, Zhong-Min; Cao, Hui-Fang; Ren, Jia-Wei; Zhao, Jing-Ya; Wang, Chang-Hui; Lu, Hong-Zhou; Li, Jun; Hu, Yang; Liang, Shuo; Jie, Zhi-Jun; Qu, Jie-Ming; Xu, Jin-Fu.
  • Mao B; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Liu Y; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Chai YH; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Jin XY; Department of Pulmonary and Critical Care Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Lu HW; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Yang JW; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Gao XW; Department of Respiratory and Critical Care Medicine, Minhang Hospital, Fudan University, Shanghai, China.
  • Song XL; Department of Respiratory and Critical Medicine, Shanghai Tenth People's Hospital, Shanghai, China.
  • Bao H; Department of Respiratory Medicine, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China.
  • Wang A; Department of Medical Management, Zhoupu Hospital of Pudong New District, Shanghai, China.
  • Gu WC; Department of Respiratory Medicine, Shanghai Pudong New Area People's Hospital, Shanghai, China.
  • Zhao L; Department of Pulmonary and Critical Care Medicine, Gongli Hospital, Shanghai, China.
  • Pan JP; Department of Infectious Disease, Shanghai Nanhua Hospital of Pudong New District, Shanghai, China.
  • Li F; Department of Respiratory and Critical Care Medicine, Songjiang Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Zhang TF; Department of Respiratory Medicine, Baoshan Branch of Renji Hospital, Shanghai, China.
  • Qian YC; Department of Respiratory Medicine, Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China.
  • Du CL; Department of Respiratory Medicine Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China.
  • Ding W; Department of Respiratory Medicine, Shanghai Punan Hospital of Pudong New District, Shanghai, China.
  • Tu CL; Department of Respiratory and Critical Care Medicine, Jiading Center Hospital, Shanghai University of Medicine & Health Sciences, Shanghai, China.
  • Chu DJ; Department of Respiratory and Critical Care Medicine, Shanghai Eighth People's Hospital, Shanghai, China.
  • Li C; Department of Respiratory and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China.
  • Ye L; Department of Respiratory and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China.
  • Luo Y; Department of Respiratory Medicine, Chongming Branch of Xin Hua Hospital Affiliated to School of Medicine, Jiaotong University, Shanghai, China.
  • Zheng CX; Department of Respiratory and Critical Care Medicine, Yangpu Hospital, Tongji University, Shanghai, China.
  • Yu RH; Department of Respiratory Medicine, Xuhui District Central Hospital, Shanghai, China.
  • Qiu ZM; Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
  • Cao HF; Department of Respiratory Medicine, Jing'an District Centre Hospital of Shanghai, Shanghai, China.
  • Ren JW; Department of Respiratory Medicine, Shanghai Fourth People's Hospital, Shanghai, China.
  • Zhao JY; Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Wang CH; Department of Respiratory and Critical Medicine, Shanghai Tenth People's Hospital, Shanghai, China.
  • Lu HZ; Shanghai Public Health Clinical Center, Shanghai, China.
  • Li J; Clinical Research Unit, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Hu Y; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Liang S; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
  • Jie ZJ; Department of Respiratory and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
  • Qu JM; Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Xu JF; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Lancet Digit Health ; 2(6): e323-e330, 2020 06.
Article in English | MEDLINE | ID: covidwho-260619
ABSTRACT

Background:

The outbreak of COVID-19 has led to international concern. We aimed to establish an effective screening strategy in Shanghai, China, to aid early identification of patients with COVID-19.

Methods:

We did a multicentre, observational cohort study in fever clinics of 25 hospitals in 16 districts of Shanghai. All patients visiting the clinics within the study period were included. A strategy for COVID-19 screening was presented and then suspected cases were monitored and analysed until they were confirmed as cases or excluded. Logistic regression was used to determine the risk factors of COVID-19.

Findings:

We enrolled patients visiting fever clinics from Jan 17 to Feb 16, 2020. Among 53 617 patients visiting fever clinics, 1004 (1·9%) were considered as suspected cases, with 188 (0·4% of all patients, 18·7% of suspected cases) eventually diagnosed as confirmed cases. 154 patients with missing data were excluded from the analysis. Exposure history (odds ratio [OR] 4·16, 95% CI 2·74-6·33; p<0·0001), fatigue (OR 1·56, 1·01-2·41; p=0·043), white blood cell count less than 4 × 109 per L (OR 2·44, 1·28-4·64; p=0·0066), lymphocyte count less than 0·8 × 109 per L (OR 1·82, 1·00-3·31; p=0·049), ground glass opacity (OR 1·95, 1·32-2·89; p=0·0009), and having both lungs affected (OR 1·54, 1·04-2·28; p=0·032) were independent risk factors for confirmed COVID-19.

Interpretation:

The screening strategy was effective for confirming or excluding COVID-19 during the spread of this contagious disease. Relevant independent risk factors identified in this study might be helpful for early recognition of the disease.

Funding:

National Natural Science Foundation of China.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Lancet Digit Health Year: 2020 Document Type: Article Affiliation country: S2589-7500(20)30109-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Lancet Digit Health Year: 2020 Document Type: Article Affiliation country: S2589-7500(20)30109-6