Epidemiological and Clinical Features of Imported and Local Patients with Coronavirus Disease 2019 (COVID-19) in Hainan, China

Abstract

Background Hainan Island, a popular tourist destination, had received many imported cases of Coronavirus disease 2019 (COVID-19), but successfully contained the epidemics in one month. We described epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas. Methods We included 91 patients (56 imported and 35 local cases) from two designed hospitals for COVID-19 in Haikou, China, from January 20 to February 19, 2020. Data on demographic, epidemiological, clinical and laboratory characteristics were extracted from medical records. Results Of the 91 patients, 78 (85.7%) patients were diagnosed within the rst three weeks after the rst case identi ed (Day 1: Jan 22, 2020), while the number of local cases started to increase from the third week. No new cases occurred after Day 29. Fever and cough were two main clinical manifestations. 15 (16.5%) were severe, 14 (15.4%) had complicated infections, nine (9.9%) were admitted to ICU, and three died. Median duration of viral shedding in feces was longer than that in nasopharyngeal swabs (19 days vs 16 days, P =0.007). Compared with local cases, imported cases were older, have higher incidence of fever and concurrent infections. There was no difference in outcomes between the two groups. Conclusion Imported cases were more severe than local cases, but could have similar prognosis. The short epidemic period in Hainan suggests that the epidemics could be quickly brought under control if proper timely measures were taken.

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

“…Of the 79 papers included, 58 studies were done in China (appendix pp 1-4). 2,10-12, [14][15][16][17][19][20][21][23][24][25][26][27][28][35][36][37][38][39][40][41]43,44,[48][49][50][52][53][54][55][56][57][58][59][60][61][62][63][65][66][67][68][69][70][71][72][73][75][76][77][78][79][80]…”

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Insights on defeating coronavirus disease (COVID-19) outbreak and predicting tourist arrival on the Chinese Hainan Leisure Island during the COVID-19 pandemic

“…Standardized and humanized management should be carried out for the retained viewpoints, and the unqualified retained viewpoints should be promptly reformed. These include extensive contact tracing and border control measures and community-transmission control measures, [ 17 ] including cancelling the leave of personnel in key positions and ensuring that relevant personnel are on duty during holidays and implementation of the territorial responsibility system. Governments worldwide should immediately set up a novel COVID-19 epidemic prevention and control organization that would strengthen the control of people entering the island.…”

Quantifying the relationship between SARS-CoV-2 wastewater concentrations and building-level COVID-19 prevalence at an isolation residence using a passive sampling approach

“…However, prolonged fecal shedding of SARS-CoV-2 RNA has been documented up to 47 days following symptom onset, sometimes persisting in stool for more than two weeks after negative oropharyngeal swabs (Cheung et al, 2020; Fei Xiao et al, 2020; Ling et al, 2020; Y. Wu et al, 2020; Cevik et al, 2021; Nalbandian et al, 2021). It has been estimated that SARS-CoV-2 RNA in stool is detected in nearly 66% of infected patients and can be measured in feces as soon as two days after symptom onset (Lo et al, 2020; Chan et al, 2021).…”

“…It has been estimated that SARS-CoV-2 RNA in stool is detected in nearly 66% of infected patients and can be measured in feces as soon as two days after symptom onset (Lo et al, 2020; Chan et al, 2021). Evidence suggests that both symptomatic and asymptomatic individuals shed SARS-CoV-2 in both respiratory and stool specimens, highlighting the critical role WBE can play in capturing asymptomatic or subclinical cases that may otherwise not be identified (Wu et al, 2020; Xiao et al, 2020; Han et al, 2020; Lo et al, 2020; Wölfel et al, 2020; Zhang et al, 2020; Zhou et al, 2020). Yet, differences in viral shedding rates based on symptom status and disease time course have been detailed, making it difficult to quantitatively interpret SARS-CoV-2 wastewater concentrations, especially to estimate infection prevalence (Zheng et al, 2020).…”