M NCOV19

Clinical Characteristics of 2019 Novel Coronavirus Infection

Rajesh T. Gandhi, MD reviewing Chen N et al. Lancet 2020 Jan 30

About half of those admitted to one hospital with this infection had comorbid conditions, and deaths occurred mainly in older individuals.

Transmission of the Novel Coronavirus: Early Findings

Richard T. Ellison III, MD reviewing Li Q et al. N Engl J Med 2020 Jan 29

In the early period of the 2019 novel coronavirus epidemic, the mean incubation period was 5.2 days, but many patients had no identified exposure.

Clinical Characteristics of 2019 Novel Coronavirus Infection

Rajesh T. Gandhi, MD reviewing Chen N et al. Lancet 2020 Jan 30 About half of those admitted to one hospital with this infection had comorbid conditions, and deaths occurred mainly in older individuals. The clinical spectrum of 2019 novel coronavirus (2019-nCoV) infection is still being defined. Now, investigators describe the characteristics of 99 people with confirmed 2019-nCoV pneumonia who were admitted to one infectious diseases specialty hospital between January 1 and 20, 2020, in Wuhan, China. The patients' average age was 55; two thirds were men; 47 had long-term exposure (e.g., salesmen, market managers) and 2 had short-term exposure (shoppers) to the Huanan seafood market. About 50% had chronic conditions, most commonly cardiovascular and cerebrovascular diseases (40%). At hospital admission, symptoms and signs included fever (83%), cough (82%), and shortness of breath (31%); few patients had sore throat, rhinorrhea, or gastrointestinal symptoms (≤5% each). Laboratory findings included liver function abnormalities (43%) and lymphopenia (35%). On chest x-ray or computed tomography, 75% had evidence of bilateral pneumonia; 1 person had a pneumothorax. Complications at time of presentation included acute respiratory distress syndrome (17%), acute kidney injury (3%), and septic shock (4%). By January 25, 11 patients (11%) had died. Seven of the deaths were in people over 60 years old.

COMMENT This case series suggests that severe disease due to 2019-nCoV infection is most likely to occur in older people with comorbid conditions, as is the case with influenza and many other infectious diseases. Because this study focused on hospitalized patients, the full spectrum of disease is not yet known. Specifically, we need data on less-severely affected individuals and serologic testing of populations to estimate the frequency of asymptomatic infection