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  • Comprehensive Ophthalmology

    Review of: Clinical Characteristics of Coronavirus Disease 2019 in China

    Guan W, Ni Z, Hu Y, et al. New England Journal of Medicine, February 28, 2020

    Researchers examined the clinical characteristics of 1,099 patients with laboratory-confirmed COVID-19 from China.

    Study design

    The patients in the study were seen at 552 hospitals in 30 provinces, autonomous regions and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an ICU, the use of mechanical ventilation or death.

    Outcomes

    Median age of the cohort was 47 years. Approximately 5% of patients were admitted to the ICU, 2.3% received mechanical ventilation and 1.4% died. During first 2 months of the COVID-19 outbreak in China, less than half of patients presented with fever (43.8% on admission, 88.7% during hospitalization). Other symptoms included cough (68%) and diarrhea (4%). More than half of patients showed ground-glass opacity on CT scans (56.4%). Only 1.9% of the patients had a history of direct contact with wildlife.

    Limitations

    This study was only done during the early portion of the outbreak and does not include long-term data. As a result, the findings may underestimate primary endpoints (i.e., ICU, vent, death). The authors did not report the rate of conjunctivitis within this cohort. The study period was limited to cases between Dec. 11, 2019, to Jan. 29, 2020; data cut off was Jan. 31, 2020.

    Clinical significance

    The spread of COVID-19 occurred rapidly throughout China and caused varying degrees of illness. These findings show that patients often presented without fever, and many did not have abnormal radiologic findings.