A descriptive study of the impact of diseases control and prevention on the epidemics dynamics and clinical features of SARS-CoV-2 outbreak in Shanghai, lessons learned for metropolis epidemics prevention

Abstract

Objective: To describe and evaluate the impact of diseases control and prevention on epidemics dynamics and clinical features of SARS-CoV-2 outbreak in Shanghai. Design: A retrospective descriptive study Setting: China Participants: Epidemiology information was collected from publicly accessible database. 265 patients admitted to Shanghai Public Health Center with confirmed COVID-19 were enrolled for clinical features analysis. Main outcome measure: Prevention and control measures taken by Shanghai government, epidemiological, demographic, clinical, laboratory and radiology data were collected. Weibull distribution, Chi-square test, Fisher's exact test, t test or Mann-Whitney U test were used in statistical analysis. Results: COVID-19 transmission rate within Shanghai had reduced over 99% than previous speculated, and the exponential growth has been stopped so far. Epidemic was characterized by the first stage mainly composed of imported cases and the second stage where >50% of cases were local. The incubation period was 6.4 (95% CI 5.3 to 7.6) days and the mean onset-admission interval was 5.5 days (95% CI, 5.1 to 5.9). Median time for COVID-19 progressed to severe diseases were 8.5 days (IQR: 4.8-11.0 days). By February 11th, proportion of patients being mild, moderate, severe and critically ill were 1.9%(5/265), 89.8%(238/265), 3.8%(10/265), 4.5%(12/265), respectively; 47 people in our cohort were discharged, and 1 patient died. Conclusion: Strict controlling of the transmission rate at the early stage of an epidemic in metropolis can quickly prohibit the spread of the diseases. Controlling local clusters is the key to prevent outbreaks from imported cases. Most COVID-19 severe cases progressed within 14 days of disease onset. Multiple systemic laboratory abnormalities had been observed before significant respiratory dysfunction. Keyword: COVID-19, SARS-CoV-2, epidemics dynamics, diseases control, clinical features

Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease

“…16 Serum levels of ALT and AST in severe to critical cases were significantly higher than those in mild to moderate cases among 265 patients with COVID-19 from Shanghai. 17 Similarly, patients admitted to the ICU were more likely to have high levels of serum ALT, AST, and total bilirubin. 18,19 In 52 critically ill patients with multiple organ damage, 35 (67%) had ARDS, 15 (29%) had acute kidney injury, 15 (29%) had liver injury, and 12 (23%) had cardiac injury.…”

Clinical Pathway for Early Diagnosis of COVID-19: Updates from Experience to Evidence-Based Practice

“…Huang reported that prothrombin time and D-dimer levels on admission were higher in intensive care unit (ICU) patients than in non-ICU patients [11]. Plasma concentrations of IL-2, IL-7, Zhang et al [46] Liu et al [47] Yang et al [48] Wang et al [45] Lu et al [49] Liu et al [50] Huang et al [11] Liu et al [51] Chen et al [ IL-10, and TNF-α were higher in ICU patients. In Wang's study [45], ICU patients had higher white blood cell and neutrophil counts, as well as higher levels of D-dimer, creatine kinase, and creatine.…”

CT and COVID-19: Chinese experience and recommendations concerning detection, staging and follow-up

“…CT findings are not always consistent with RT-PCR, which is not surprising as CT and RT-PCR do not explore the same issues. Some patients with positive RT-PCR had normal CT [2,6], but may later develop pneumonia, while others would not [6]. Some patients with negative RT-PCR results had marked viral pneumonia features on CT; some RT-PCR results would become positive after repeated tests with about a mean Please note that due to the time sensitive nature of the work presented in this article, standard peer-review has been bypassed to ensure rapid publication.…”